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Sample records for kidney 2-vessel cord

  1. Renoprotective Effect of Human Umbilical CordDerived Mesenchymal Stem Cells in Immunodeficient Mice Suffering from Acute Kidney Injury

    PubMed Central

    Fang, Te-Chao; Pang, Cheng-Yoong; Chiu, Sheng-Chun; Ding, Dah-Ching; Tsai, Rong-Kung

    2012-01-01

    It is unknown whether human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) can improve the renal function of patients suffering from acute kidney injury. Moreover, before beginning clinical trials, it is necessary to investigate this renoprotective effect of hUC-MSCs in a xenogeneic model of acute kidney injury. However, no previous studies have examined the application of hUC-MSCs to immunodeficient mice suffering from acute kidney injury. The objectives of this study were to examine whether hUC-MSCs could improve renal function in nonobese diabetic-severe combined immune deficiency (NOD-SCID) mice suffering from acute kidney injury, and to investigate the mechanism(s) for hUC-MSCs to improve renal function in this xenogeneic model. Early (3 hr) and late (12 hr) administrations of hUC-MSCs (106 cells) were performed via the external jugular vein into NOD-SCID mice suffering from either folic acid (FA) (250 mg/kg body weight) or vehicle. The results showed that early administration of hUC-MSCs improved the renal function of NOD-SCID mice suffering from FA-induced acute kidney injury, as evidenced by decreased serum urea nitrogen and serum creatinine levels, as well as a reduced tubular injury score. The beneficial effects of hUC-MSCs were through reducing apoptosis and promoting proliferation of renal tubular cells. These benefits were independent of inflammatory cytokine effects and transdifferentiation. Furthermore, this study is the first one to show that the reduced apoptosis of renal tubular cells by hUC-MSCs in this xenogeneic model is mediated through the mitochondrial pathway, and through the increase of Akt phosphorylation. PMID:23029541

  2. Transplantation of differentiated umbilical cord mesenchymal cells under kidney capsule for control of type I diabetes in rat.

    PubMed

    Moshrefi, Mojgan; Yari, Nahid; Nabipour, Fatemeh; Bazrafshani, Mohammad Reza; Nematollahi-mahani, Seyed Noureddin

    2015-08-01

    Nowadays, stem cells have been introduced as an appropriate source of regenerative medicine for treatment of type I diabetes. Human umbilical cord matrix-derived mesenchymal cells (hUCMC) have successfully been differentiated into insulin producing cells. The isolated hUCM cells were characterized by the expression of stem cell surface markers and by differentiation into adipocytes and osteocytes. The hUCMCs were cultured with different concentrations of neural conditional medium (NCM) and were induced to differentiate into insulin producing cells (IPCs). As 60% NCM concentration resulted in higher nestin and PDX1 expression, the cells were first exposed to 60% NCM and were then induced for IPCs differentiation. PDX1 and insulin gene expression was evaluated in the treated cells. Also, the secretion capacity of the IPCs was assessed by glucose challenge test. IPCs were transferred under the rat kidney capsule. Blood glucose level, weight gain and immunohistochemistry assessments were done in the treated animals. hUCMC expressed mesenchymal cell surface markers and successfully differentiated into adipocytes and osteocytes. Higher NCM concentration resulted in higher PDX1 and nestin expression. The IPCs expressed insulin and PDX1. IPCs were detectable under the kidney capsule 2 months after injection. IPCs transplantation resulted in a sharp decline of blood sugar level and less weight loss. Differentiated hUCM cells could alleviate the insulin deprivation in the rat model of type I diabetes. In addition, higher NCM concentration leads to more differentiation into IPCs and more nestin and PDX1 expression. Kidney capsule can serve as a suitable nominee for IPCs transplantation. PMID:26025422

  3. Kidney.

    PubMed

    Hart, A; Smith, J M; Skeans, M A; Gustafson, S K; Stewart, D E; Cherikh, W S; Wainright, J L; Boyle, G; Snyder, J J; Kasiske, B L; Israni, A K

    2016-01-01

    Kidney transplant provides significant survival, cost, and quality-of-life benefits over dialysis in patients with end-stage kidney disease, but the number of kidney transplant candidates on the waiting list continues to grow annually. By the end of 2014, nearly 100,000 adult candidates and 1500 pediatric candidates were waiting for kidney transplant. Not surprisingly, waiting times also continued to increase, along with the number of adult candidates removed from the list due to death or deteriorating medical condition. Death censored graft survival has increased after both living and deceased donor transplants over the past decade in adult recipients. The majority of the trends seen over the past 5 years continued in 2014. However, the new allocation system was implemented in late 2014, providing an opportunity to assess changes in these trends in the coming years. PMID:26755262

  4. Improved Protective Effect of Umbilical Cord Stem Cell Transplantation on Cisplatin-Induced Kidney Injury in Mice Pretreated with Antithymocyte Globulin

    PubMed Central

    Večerić-Haler, Željka; Erman, Andreja; Cerar, Anton; Motaln, Helena; Kološa, Katja; Lah Turnšek, Tamara; Sodin Šemrl, Snežna; Lakota, Katja; Mrak-Poljšak, Katjuša; Škrajnar, Špela; Kranjc, Simona; Arnol, Miha; Perše, Martina

    2016-01-01

    Mesenchymal stem cells (MSCs) are recognised as a promising tool to improve renal recovery in experimental models of cisplatin-induced acute kidney injury. However, these preclinical studies were performed on severely immunodeficient animals. Here, we investigated whether human umbilical cord derived MSC treatment could equally ameliorate acute kidney injury induced by cisplatin and prolong survival in mice with a normal immune system and those with a suppressed immune system by polyclonal antithymocyte globulin (ATG). We demonstrated that ATG pretreatment, when followed by MSC transplantation, significantly improved injured renal function parameters, as evidenced by decreased blood urea nitrogen and serum creatinine concentration, as well as improved renal morphology. This tissue restoration was also supported by increased survival of mice. The beneficial effects of ATG were associated with reduced level of inflammatory protein serum amyloid A3 and induced antioxidative expression of superoxide dismutase-1 (SOD-1), glutathione peroxidase (GPx), and hem oxygenase-1 (HO-1). Infused MSCs became localised predominantly in peritubular areas and acted to reduce renal cell death. In conclusion, these results show that ATG diminished in situ inflammation and oxidative stress associated with cisplatin-induced acute kidney injury, the effects that may provide more favourable microenvironment for MSC action, with consequential synergistic improvements in renal injury and animal survival as compared to MSC treatment alone. PMID:26880955

  5. Extracellular membrane vesicles from umbilical cord blood-derived MSC protect against ischemic acute kidney injury, a feature that is lost after inflammatory conditioning

    PubMed Central

    Kilpinen, Lotta; Impola, Ulla; Sankkila, Lotta; Ritamo, Ilja; Aatonen, Maria; Kilpinen, Sami; Tuimala, Jarno; Valmu, Leena; Levijoki, Jouko; Finckenberg, Piet; Siljander, Pia; Kankuri, Esko; Mervaala, Eero; Laitinen, Saara

    2013-01-01

    Background Mesenchymal stromal cells (MSC) are shown to have a great therapeutic potential in many immunological disorders. Currently the therapeutic effect of MSCs is considered to be mediated via paracrine interactions with immune cells. Umbilical cord blood is an attractive but still less studied source of MSCs. We investigated the production of extracellular membrane vesicles (MVs) from human umbilical cord blood derived MSCs (hUCBMSC) in the presence (MVstim) or absence (MVctrl) of inflammatory stimulus. Methods hUCBMSCs were cultured in serum free media with or without IFN-γ and MVs were collected from conditioned media by ultracentrifugation. The protein content of MVs were analyzed by mass spectrometry. Hypoxia induced acute kidney injury rat model was used to analyze the in vivo therapeutic potential of MVs and T-cell proliferation and induction of regulatory T cells were analyzed by co-culture assays. Results Both MVstim and MVctrl showed similar T-cell modulation activity in vitro, but only MVctrls were able to protect rat kidneys from reperfusion injury in vivo. To clarify this difference in functionality we made a comparative mass spectrometric analysis of the MV protein contents. The IFN-γ stimulation induced dramatic changes in the protein content of the MVs. Complement factors (C3, C4A, C5) and lipid binding proteins (i.e apolipoproteins) were only found in the MVctrls, whereas the MVstim contained tetraspanins (CD9, CD63, CD81) and more complete proteasome complex accompanied with MHCI. We further discovered that differently produced MV pools contained specific Rab proteins suggesting that same cells, depending on external signals, produce vesicles originating from different intracellular locations. Conclusions We demonstrate by both in vitro and in vivo models accompanied with a detailed analysis of molecular characteristics that inflammatory conditioning of MSCs influence on the protein content and functional properties of MVs revealing the complexity of the MSC paracrine regulation. PMID:24349659

  6. Enhanced renoprotective effect of IGF-1 modified human umbilical cord-derived mesenchymal stem cells on gentamicin-induced acute kidney injury

    PubMed Central

    Liu, Pengfei; Feng, Yetong; Dong, Delu; Liu, Xiaobo; Chen, Yaoyu; Wang, Yi; Zhou, Yulai

    2016-01-01

    The therapeutic action of umbilical cord-derived mesenchymal stem cells (UC-MSCs) against acute kidney injury (AKI) has been demonstrated by several groups. However, how to further enhance the renoprotective effect of UC-MSCs and improve the therapy effect, are still unclear. In this study, we mainly investigated whether insulin-like growth factor-1 (IGF-1)-modified UC-MSCs hold an enhanced protective effect on gentamicin-induced AKI in vivo. Our results indicated that the IGF-1 overexpression could enhance the therapeutic action of human UC-MSCs, and the AKI rats treated with IGF-1-overexpressed UC-MSCs (UC-MSCs-IGF-1) showed better recovery of biochemical variables in serum or urine associated with renal function, histological injury and renal apoptosis, compared with AKI rats treated with normal UC-MSCs. RNA microarray analysis indicated that some key genes in the signal pathways associated with anti-oxidation, anti-inflammatory, and cell migratory capacity were up-regulated in UC-MSCs-IGF-1, and the results were further confirmed with qPCR. Furthermore, a series of detection in vitro and in vivo indicated that the UC-MSCs-IGF-1 hold better anti-oxidation, anti-inflammatory, and cell migratory capacity for IGF-1 overexpression. Thus, our study indicated that enhancement of UC-MSCs bioactivities with IGF-1 overexpression could increase the UC-MSCs therapeutic potential and further developed a new therapeutic strategy for the treatment of AKI. PMID:26830766

  7. Enhanced renoprotective effect of IGF-1 modified human umbilical cord-derived mesenchymal stem cells on gentamicin-induced acute kidney injury.

    PubMed

    Liu, Pengfei; Feng, Yetong; Dong, Delu; Liu, Xiaobo; Chen, Yaoyu; Wang, Yi; Zhou, Yulai

    2016-01-01

    The therapeutic action of umbilical cord-derived mesenchymal stem cells (UC-MSCs) against acute kidney injury (AKI) has been demonstrated by several groups. However, how to further enhance the renoprotective effect of UC-MSCs and improve the therapy effect, are still unclear. In this study, we mainly investigated whether insulin-like growth factor-1 (IGF-1)-modified UC-MSCs hold an enhanced protective effect on gentamicin-induced AKI in vivo. Our results indicated that the IGF-1 overexpression could enhance the therapeutic action of human UC-MSCs, and the AKI rats treated with IGF-1-overexpressed UC-MSCs (UC-MSCs-IGF-1) showed better recovery of biochemical variables in serum or urine associated with renal function, histological injury and renal apoptosis, compared with AKI rats treated with normal UC-MSCs. RNA microarray analysis indicated that some key genes in the signal pathways associated with anti-oxidation, anti-inflammatory, and cell migratory capacity were up-regulated in UC-MSCs-IGF-1, and the results were further confirmed with qPCR. Furthermore, a series of detection in vitro and in vivo indicated that the UC-MSCs-IGF-1 hold better anti-oxidation, anti-inflammatory, and cell migratory capacity for IGF-1 overexpression. Thus, our study indicated that enhancement of UC-MSCs bioactivities with IGF-1 overexpression could increase the UC-MSCs therapeutic potential and further developed a new therapeutic strategy for the treatment of AKI. PMID:26830766

  8. TMI-2 Vessel Investigation Project integration report

    SciTech Connect

    Wolf, J. R.; Rempe, J. L.; Stickler, L. A.; Korth, G. E.; Diercks, D. R.; Neimark, L. A.; Akers, D W; Schuetz, B. K.; Shearer, T L; Chavez, S. A.; Thinnes, G. L.; Witt, R. J.; Corradini, M L; Kos, J. A.

    1994-03-01

    The Three Mile Island Unit 2 (TMI-2) Vessel Investigation Project (VIP) was an international effort that was sponsored by the Nuclear Energy Agency of the Organization for Economic Cooperation and Development. The primary objectives of the VIP were to extract and examine samples from the lower head and to evaluate the potential modes of failure and the margin of structural integrity that remained in the TMI-2 reactor vessel during the accident. This report presents a summary of the major findings and conclusions that were developed from research during the VIP. Results from the various elements of the project are integrated to form a cohesive understanding of the vessel`s condition after the accident.

  9. Spinal cord trauma

    MedlinePLUS

    Spinal cord injury; Compression of spinal cord; SCI; Cord compression ... them more likely to fall may also have spinal cord injury. ... vary depending on the location of the injury. Spinal cord injury causes weakness and loss of feeling at, and ...

  10. Cord Blood and Transplants

    MedlinePLUS

    ... network Recruitment centers International donor centers Cord blood banks Cooperative registries Transplant centers Standards Donor centers Our ... umbilical cord blood to a public cord blood bank. We have 209,000 cord blood units listed ...

  11. Kidney Disease

    MedlinePLUS

    ... How Can I Help a Friend Who Cuts? Kidney Disease KidsHealth > For Teens > Kidney Disease Print A ... Syndrome Coping With Kidney Conditions What Do the Kidneys Do? You might never think much about some ...

  12. Kidney Cysts

    MedlinePLUS

    ... fluid-filled sac. There are two types of kidney cysts. Polycystic kidney disease (PKD) runs in families. In PKD, the ... place of the normal tissue. They enlarge the kidneys and make them work poorly, leading to kidney ...

  13. Kidney Transplant

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  14. Kidney Biopsy

    MedlinePLUS

    ... More Information American Kidney Fund National Kidney Foundation Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations​​ . (PDF, 345 KB) Alternate Language URL Kidney Biopsy Page Content On this page: What is ...

  15. Kidney Failure

    MedlinePLUS

    ... an AKF screening Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... our Northeast Region. Kidney Action Day Kidney Action Day Our late spring event is an elegant fundraiser ...

  16. Kidney Biopsy

    MedlinePLUS

    ... More Information American Kidney Fund National Kidney Foundation Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations?? . (PDF, 345 KB) Alternate Language URL Kidney Biopsy Page Content On this page: What is ...

  17. Kidney Disease

    MedlinePLUS

    ... version of this page please turn Javascript on. Kidney Disease What is Kidney Disease? What the Kidneys Do Click for more information You have two ... damaged, wastes can build up in the body. Kidney Function and Aging Kidney function may be reduced ...

  18. Spinal Cord Injury Map

    MedlinePLUS

    ... Counseling About Blog Facing Disability Jeff Shannon Donate Spinal Cord Injury Map Loss of function depends on what part ... control. Learn more about spinal cord injuries. A spinal cord injury affects the entire family FacingDisability is designed to ...

  19. Spinal Cord Injury

    MedlinePLUS

    ... Types of illnesses and disabilities Spinal cord injury Spinal cord injury Read advice from Dr. Jeffrey Rabin , a pediatric ... your health on a daily basis. Living with spinal cord injury — your questions answered top What are pediatric rehabilitation ...

  20. Spinal Cord Diseases

    MedlinePLUS

    Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back ... of the spine, this can also injure the spinal cord. Other spinal cord problems include Tumors Infections such ...

  1. Tethered Spinal Cord Syndrome

    MedlinePLUS

    ... Enhancing Diversity Find People About NINDS NINDS Tethered Spinal Cord Syndrome Information Page Table of Contents (click to ... being done? Clinical Trials Organizations What is Tethered Spinal Cord Syndrome? Tethered spinal cord syndrome is a neurological ...

  2. Kidney Problems

    MedlinePLUS

    ... our e-newsletter! Aging & Health A to Z Kidney Problems Basic Facts & Information The kidneys are two ... the production of red blood cells. What are Kidney Diseases? For about one-third of older people, ...

  3. Kidney School

    MedlinePLUS

    ... copies? Read our licensing agreement Living Successfully with Kidney Disease People with kidney disease can live long ... Listen Printing multiple copies? Read our licensing agreement Kidneys: How They Work, How They Fail, What You ...

  4. Kidney Transplantation

    MedlinePLUS

    ... your body. The transplanted kidney takes over the work of the two kidneys that failed, so you no longer need dialysis. During a transplant, the surgeon places the new kidney in your lower abdomen and ...

  5. Spinal cord contusion

    PubMed Central

    Ju, Gong; Wang, Jian; Wang, Yazhou; Zhao, Xianghui

    2014-01-01

    Spinal cord injury is a major cause of disability with devastating neurological outcomes and limited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result. PMID:25206890

  6. Kidney Cysts

    MedlinePLUS

    MENU Return to Web version Kidney Cysts Overview What do the kidneys do? The kidneys remove waste from your blood. They do this by filtering the blood and making urine. What are kidney cysts? As people get older, sacs filled with ...

  7. Solitary Kidney

    MedlinePLUS

    ... Institute, Inc., Kidney School National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Solitary Kidney Page Content On this page: What is a ...

  8. Spinal Cord Injury

    MedlinePLUS

    ... Awards Enhancing Diversity Find People About NINDS NINDS Spinal Cord Injury Information Page Condensed from Spinal Cord Injury: Hope ... en Español Additional resources from MedlinePlus What is Spinal Cord Injury? A spinal cord injury usually begins with a ...

  9. Kidney: polycystic kidney disease.

    PubMed

    Paul, Binu M; Vanden Heuvel, Gregory B

    2014-01-01

    Polycystic kidney disease (PKD) is a life-threatening genetic disorder characterized by the presence of fluid-filled cysts primarily in the kidneys. PKD can be inherited as autosomal recessive (ARPKD) or autosomal dominant (ADPKD) traits. Mutations in either the PKD1 or PKD2 genes, which encode polycystin 1 and polycystin 2, are the underlying cause of ADPKD. Progressive cyst formation and renal enlargement lead to renal insufficiency in these patients, which need to be managed by lifelong dialysis or renal transplantation. While characteristic features of PKD are abnormalities in epithelial cell proliferation, fluid secretion, extracellular matrix and differentiation, the molecular mechanisms underlying these events are not understood. Here we review the progress that has been made in defining the function of the polycystins, and how disruption of these functions may be involved in cystogenesis. PMID:25186187

  10. Tests for Kidney Health

    MedlinePLUS

    ... kidney disease Free kidney health screenings Free kidney health screenings The American Kidney Fund offers free health ... blood. Tests for kidney health Tests for kidney health The only way to know if your kidneys ...

  11. Kidney Diseases

    MedlinePLUS

    Your kidneys are two bean-shaped organs, each about the size of your fists. They are located near the ... back, just below the rib cage. Inside each kidney about a million tiny structures called nephrons filter ...

  12. Kidney Failure

    MedlinePLUS

    Healthy kidneys clean your blood by removing excess fluid, minerals, and wastes. They also make hormones that keep your ... strong and your blood healthy. But if the kidneys are damaged, they don't work properly. Harmful ...

  13. Kidney Dysplasia

    MedlinePLUS

    ... Dimes National Kidney Foundation Urology Care Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Kidney Dysplasia Page Content On this page: What is ...

  14. Idiopathic spinal cord herniation.

    PubMed

    Miura, Y; Mimatsu, K; Matsuyama, Y; Yoneda, M; Iwata, H

    1996-02-01

    Idiopathic spinal cord herniation is a rare disease, few cases having been reported. We encountered a case of idiopathic spinal cord herniation presenting with severe spasticity in the right leg and urinary dysfunction. The spinal cord was herniated into a cavity created by duplication of the dura mater and resection of the inner layer improved the neurological deficits. MRI, myelography, and CT myelography were useful for diagnosing this disease. Four radiological signs of spinal cord herniation are described. PMID:8692428

  15. Spinal Cord Injuries

    MedlinePLUS

    ... forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... down on the nerve parts that carry signals. Spinal cord injuries can be complete or incomplete. With a complete ...

  16. Spinal Cord Infarction

    MedlinePLUS

    ... 800-225-0292 Fax: 973-912-9433 National Spinal Cord Injury Association 120-34 Queens Boulevard, #1320 Kew Gardens, ... 785-4452 Related NINDS Publications and Information NINDS Spinal Cord Injury Information Page Spinal cord injury information sheet compiled ...

  17. Chronic Kidney Disease (CKD)

    MedlinePLUS

    ... ago. Kidney Disease About your kidneys About your kidneys Your kidneys are vital organs that remove waste ... long as possible. Kidney-friendly diet for CKD Kidney-friendly diet You may be able to prevent ...

  18. Ectopic Kidney

    MedlinePLUS

    ... Human Development March of Dimes National Office MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Ectopic Kidney Page Content On this page: What is an ...

  19. Kidney Cancer

    MedlinePLUS

    You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and ... blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes ...

  20. Umbilical cord prolapse.

    PubMed

    Chetty, R M; Moodley, J

    1980-01-26

    Filling the bladder with 400--500 ml of saline displaces the presenting part and relieves pressure on the prolapsed umbilical cord. With this method there were no perinatal deaths in 24 patients with prolpsed cord, although the average interval between diagnosis and delivery was 65,0 minutes. This method has several advantages over other first-aid measures to relieve pressure on the prolapsed cord. PMID:7404122

  1. Chronic Kidney Diseases

    MedlinePLUS

    ... Skiing, Snowboarding, Skating Crushes What's a Booger? Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases Print ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  2. Kidney disease - resources

    MedlinePLUS

    Resources - kidney disease ... The following organizations are good resources for information on kidney disease: National Kidney Disease Education Program -- www.nkdep.nih.gov National Kidney Foundation -- www.kidney.org National ...

  3. Kidney Facts

    MedlinePLUS

    ... the kidneys is to remove waste from the body through the production of urine. They also help to regulate blood pressure, blood volume and the chemical (electrolyte) composition of the blood. Content on this page requires ...

  4. Kidney Failure

    MedlinePLUS

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. October 2, 2013 Contact Us Health Information Center Phone: 1-800-860- ...

  5. Kidney Tumors

    Cancer.gov

    Kidney tumors are rare and generally curable in children. However, there are subsets of patients afflicted with these diseases that do not respond to treatment or eventually relapse. These patients usually have poor clinical outcomes as compared with the majority of children diagnosed with kidney tumors. All patients undergo therapy regimens that can be detrimental later in life. Through genome-wide characterization, TARGET investigators are identifying critical molecular alterations in these tumors, mostly from relapsed patients.

  6. Central Cord Syndrome

    MedlinePLUS

    ... syndrome is the most common form of incomplete spinal cord injury characterized by impairment in the arms and hands ... STANDUP (782-6387) Fax: 305-243-6017 National Spinal Cord Injury Association 120-34 Queens Boulevard, #1320 Kew Gardens, ...

  7. Calculations to estimate the margin to failure in the TMI-2 vessel

    SciTech Connect

    Stickler, L.A.; Rempe, J.L.; Chavez, S.A.; Thinnes, G.L.; Snow, S.D.; Witt, R.J.; Corradini, M.L.; Kos, J.A.

    1994-03-01

    As part of the OECD-sponsored Three Mile Island Unit 2 (TMI-2) Vessel Investigation Project (VIP), margin-to-failure calculations for mechanisms having the potential to threaten the integrity of the vessel were performed to improve understanding of events that occurred during the TMI-2 accident. Analyses considered four failure mechanisms: tube rupture, tube ejection, global vessel failure, and localized vessel failure. Calculational input was based on data from the TMI-2 VIP examinations of the vessel steel samples, the instrument tube nozzles, and samples of the hard layer of debris found on the TMI-2 vessel lower head. Sensitivity studies were performed to investigate the uncertainties in key parameters for these analyses.

  8. Kidney cancer.

    PubMed

    Linehan, W Marston; Rathmell, W Kimryn

    2012-01-01

    Over 65,000 Americans are diagnosed with kidney cancer each year and nearly 13,000 die of this disease. Kidney cancer is not a single disease, it is made up of a number of different types of cancer, each with a different histology, a different clinical course, responding differently to therapy and caused by a different gene. Study of the 13 genes that are known to cause kidney cancer has led to the understanding that kidney cancer is a metabolic disease. Recent discoveries of chromatin remodeling/histone modifying genes, such as PBRM1 and SETD2, have opened up new areas of intense interest in the study of the fundamental genetic basis of kidney cancer. New approaches to immunotherapy with agents such as the CTLA4 inhibitor, ipilumumab, have opened up promising new directions for clinical trials. A number of new agents targeting of VEGF receptor signaling and the mTOR pathways as well as novel approaches targeting HIF2 will hopefully provide the foundation for the development of effective forms of therapy for this disease. PMID:23218074

  9. Kidney removal - series (image)

    MedlinePLUS

    Nephrectomy may be recommended for: kidney deformities (birth defects: congenital abnormalities) injury (trauma) disease infection hypertension tumor removal of kidney from donor for kidney transplant

  10. Modeling spinal cord biomechanics

    NASA Astrophysics Data System (ADS)

    Luna, Carlos; Shah, Sameer; Cohen, Avis; Aranda-Espinoza, Helim

    2012-02-01

    Regeneration after spinal cord injury is a serious health issue and there is no treatment for ailing patients. To understand regeneration of the spinal cord we used a system where regeneration occurs naturally, such as the lamprey. In this work, we analyzed the stress response of the spinal cord to tensile loading and obtained the mechanical properties of the cord both in vitro and in vivo. Physiological measurements showed that the spinal cord is pre-stressed to a strain of 10%, and during sinusoidal swimming, there is a local strain of 5% concentrated evenly at the mid-body and caudal sections. We found that the mechanical properties are homogeneous along the body and independent of the meninges. The mechanical behavior of the spinal cord can be characterized by a non-linear viscoelastic model, described by a modulus of 20 KPa for strains up to 15% and a modulus of 0.5 MPa for strains above 15%, in agreement with experimental data. However, this model does not offer a full understanding of the behavior of the spinal cord fibers. Using polymer physics we developed a model that relates the stress response as a function of the number of fibers.

  11. About Chronic Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  12. Pregnancy and Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  13. Polycystic kidney disease

    MedlinePLUS

    Cysts - kidneys; Kidney - polycystic; Autosomal dominant polycystic kidney disease; ADPKD ... Polycystic kidney disease (PKD) is passed down through families (inherited), usually as an autosomal dominant trait. If one parent ...

  14. Diet and Kidney Stones

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  15. Kidney Stones in Children

    MedlinePLUS

    ... Nephrology American Kidney Fund National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Disease Organizations​​ . (PDF, 345 KB) Alternate Language URL Kidney Stones in Children Page Content On this page: ...

  16. Kidney Disease Basics

    MedlinePLUS

    ... Links Take the first step Alternate Language URL Kidney Disease Basics Page Content Your kidneys filter extra ... blood pressure are the most common causes of kidney disease. ​These conditions can slowly damage the kidneys ...

  17. Kidney-Pancreas Transplant

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  18. National Kidney Foundation

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  19. Chronic Kidney Disease (CKD)

    MedlinePLUS

    ... an AKF screening Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... our Northeast Region. Kidney Action Day Kidney Action Day Our late spring event is an elegant fundraiser ...

  20. American Kidney Fund

    MedlinePLUS

    ... an AKF screening Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... our Northeast Region. Kidney Action Day Kidney Action Day Our late spring event is an elegant fundraiser ...

  1. Cord-Blood Banking

    MedlinePLUS

    ... lists both public and private blood banks by geographic location The National Marrow Donor Program ( www.bethematch.org ), with information on registered cord-blood facilities that accept donations ...

  2. Cord-Blood Banking

    MedlinePLUS

    ... cord blood mainly because of the promise that stem cell research holds for the future. Most of us would have little use for stem cells now, but research into using them to treat diseases is ongoing ...

  3. Spinal Cord Injury 101

    MedlinePLUS Videos and Cool Tools

    ... is "Braingate" research? What is the status of stem-cell research? How would stem-cell therapies work in the treatment of spinal cord injuries? What does stem-cell research on animals tell us? When can we ...

  4. Cord-Blood Banking

    MedlinePLUS

    ... forming stem cells last when properly stored? In theory, stem cells should last forever, but cord-blood ... for First-Time Parents Severe Combined Immunodeficiency Genetic Counseling Genetic Testing Birthing Centers and Hospital Maternity Services ...

  5. Your Kidneys

    MedlinePLUS

    ... jobs of the kidneys is to filter the waste out of the blood . How does the waste get in your blood? Well, your blood delivers ... to break down the nutrients. Some of the waste is the result of these chemical reactions. Some ...

  6. Kidney pain (image)

    MedlinePLUS

    A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the size of sand or ... A kidney stone is a solid piece of material that forms in a kidney. Kidney stones may be the ...

  7. Depression and Spinal Cord Injury

    MedlinePLUS

    ... Urinary Tract Infections: Indwelling (Foley) Catheter Depression and Spinal Cord Injury [ Download this pamphlet: “Depression and Spinal Cord Injury” (PDF - 477KB)] Depression is a common illness that ...

  8. What Is Spinal Cord Injury?

    MedlinePLUS

    ... NICHD Research Information Clinical Trials Resources and Publications Spinal Cord Injury (SCI): Condition Information Skip sharing on social media ... 3 National Institute of Neurological Disorders and Stroke. Spinal cord injury: Hope through research. Retrieved June 19 , 2013 , from ...

  9. Overview of Spinal Cord Disorders

    MedlinePLUS

    ... Organized ). The center of the cord consists of gray matter shaped like a butterfly. The front "wings" ( ... the spinal cord, a butterfly-shaped area of gray matter helps relay impulses to and from spinal ...

  10. Spinal cord monitoring.

    PubMed

    Nuwer, M R

    1999-12-01

    Over the past two decades, intraoperative spinal cord monitoring has matured into a widely used clinical tool. It is used when the spinal cord is at risk for damage during a surgical procedure. This includes orthopedic, neurosurgical, and certain cardiothoracic procedures. Both somatosensory evoked potential (SEP) and direct motor pathway stimulation techniques are available. The SEP techniques are used most widely, are generally accepted, and have been shown to reduce surgical morbidity. A large multicenter study has shown that SEP monitoring reduces postoperative paraplegia by more than 50-60%. Techniques and literature on clinical applications are reviewed in this report. PMID:10567073

  11. Spinal cord injury pain.

    PubMed

    Saulino, Michael

    2014-05-01

    Chronic pain associated with traumatic spinal cord injury (SCI) can be quite challenging to the physiatrist. This highly prevalent condition within the SCI population requires an appropriate evaluative approach including a thorough history, a targeted physical examination, and appropriate use of diagnostic testing. The International Spinal Cord Injury Pain Classification allows for a reasonable categorization of the various pain syndromes and may assist in selecting a reasoned treatment strategy. A multitude of management approaches exist including nonpharmacologic, pharmacologic, and interventional approaches. This article provides an overview of the epidemiology, classification, evaluation, and management of SCI-associated pain. PMID:24787340

  12. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1979-01-01

    A kidney cell electrophoresis technique is described in four parts: (1) the development and testing of electrophoresis solutions; (2) optimization of freezing and thawing; (3) procedures for evaluation of separated kidney cells; and (4) electrophoretic mobility characteristics of kidney cells.

  13. Chronic kidney disease

    MedlinePLUS

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... Chronic kidney disease (CKD) slowly gets worse over months or years. You may not notice any symptoms for some ...

  14. Chronic Kidney Disease

    MedlinePLUS

    You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

  15. Diabetic Kidney Problems

    MedlinePLUS

    ... too high. Over time, this can damage your kidneys. Your kidneys clean your blood. If they are damaged, waste ... in your blood instead of leaving your body. Kidney damage from diabetes is called diabetic nephropathy. It ...

  16. Acute kidney failure

    MedlinePLUS

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  17. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1980-01-01

    The following aspects of kidney cell electrophoresis are discussed: (1) the development and testing of electrophoresis solutions; (2) optimization of freezing and thawing; (3) procedures for evaluation of separated kidney cells; and (4) electrophoretic mobility characterization of kidney cells.

  18. KIDNEY XENOTRANSPLANTATION

    PubMed Central

    Cowan, Peter J.; Cooper, David K.C.; dApice, Anthony J.F.

    2013-01-01

    Xenotransplantation using pigs as donors offers the possibility of eliminating the chronic shortage of donor kidneys, but there are several obstacles to be overcome before this goal can be achieved. Preclinical studies have shown that while porcine renal xenografts are broadly compatible physiologically, they provoke a complex rejection process involving preformed and elicited antibodies, heightened innate immune cell reactivity, dysregulated coagulation, and a strong T cell-mediated adaptive response. Furthermore, the susceptibility of the xenograft to pro-inflammatory and pro-coagulant stimuli is probably increased by cross-species molecular defects in regulatory pathways. To balance these disadvantages, xenotransplantation has at its disposal a unique tool to address particular rejection mechanisms and incompatibilities: genetic modification of the donor. This review focuses on the pathophysiology of porcine renal xenograft rejection, and on the significant genetic, pharmacological and technical progress that has been made to prolong xenograft survival. PMID:24088952

  19. Kidney xenotransplantation.

    PubMed

    Cowan, Peter J; Cooper, David K C; d'Apice, Anthony J F

    2014-02-01

    Xenotransplantation using pigs as donors offers the possibility of eliminating the chronic shortage of donor kidneys, but there are several obstacles to be overcome before this goal can be achieved. Preclinical studies have shown that, while porcine renal xenografts are broadly compatible physiologically, they provoke a complex rejection process involving preformed and elicited antibodies, heightened innate immune cell reactivity, dysregulated coagulation, and a strong T cell-mediated adaptive response. Furthermore, the susceptibility of the xenograft to proinflammatory and procoagulant stimuli is probably increased by cross-species molecular defects in regulatory pathways. To balance these disadvantages, xenotransplantation has at its disposal a unique tool to address particular rejection mechanisms and incompatibilities: genetic modification of the donor. This review focuses on the pathophysiology of porcine renal xenograft rejection, and on the significant genetic, pharmacological, and technical progress that has been made to prolong xenograft survival. PMID:24088952

  20. Kidney Disease: A Silent Problem

    MedlinePLUS

    ... Kidney Disease: A Silent Problem Heath and Aging Kidney Disease: A Silent Problem Kidney Disease Who Is ... hormones that your body needs to stay healthy. Kidney Disease Kidney disease can sometimes develop very quickly, ...

  1. Medullary Sponge Kidney

    MedlinePLUS

    ... Association of Kidney Patients National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... PDF, 345 KB)​​​​​ Alternate Language URL Medullary Sponge Kidney Page Content On this page: What is Medullary ...

  2. Simple Kidney Cysts

    MedlinePLUS

    ... Information American Kidney Fund National Kidney Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Simple Kidney Cysts Page Content On this page: What are ...

  3. Acquired Cystic Kidney Disease

    MedlinePLUS

    ... onset of disease. People with ACKD already have chronic kidney disease when they develop cysts. Kidneys Ureters Bladder What ... kidney failure and finding treatment to stop its progression. The NIDDK’s Division ... Diseases sup ports basic research into normal kidney function ...

  4. Kidney Stones

    PubMed Central

    Kleeman, Charles R.; Coburn, Jack W.; Brickman, Arnold S.; Lee, David B. N.; Narins, Robert G.; Ehrlich, Richard M.

    1980-01-01

    The prevalence of kidney stones has steadily risen during this century; passage of a calculus and a positive family history increase the probability of recurrence. Findings from recent studies on the cause of renal calculi have stressed crystallization and crystal aggregation of stone minerals from supersaturated urine, rather than excessive organic matrix. Absence of normal urine inhibitors of calcium salts is also stressed. Formation of calcium oxalate stones is the major problem. Therapy with decreased calcium and oxalate intake, thiazides, phosphate salts and allopurinol in various combinations has substantially decreased the prevalence of recurrent stones. The rationale for the use of allopurinol is that uric acid salts enhance the tendency for calcium oxalate to crystallize from supersaturated urine. The hypercalciuria seen in 30 percent to 40 percent of patients with oxalate stones is usually caused by intestinal hyperabsorption of calcium. Although patients with uric acid calculi constitute only a small fraction of those in whom stones form, they represent a group in whom good medical therapy, based on sound physiologic principles, has proved extremely successful. Renal tubular syndromes lead to nephrocalcinosis and lithiasis through hypercalciuria, alkaline urine and hypocitraturia, the latter an inhibitor of calcium salt precipitation. Recent advances in surgical techniques are discussed, including the rationale for removing staghorn calculi. The ileal ureter and coagulum pyelolithotomy deserve special emphasis. ImagesFigure 2.Figure 4.Figure 5.Figure 7. PMID:7385835

  5. Spinal Cord Injury Prevention Tips

    MedlinePLUS

    Spinal Cord Injury Prevention Tips American Association of Neurological Surgeons 5550 Meadowbrook Drive, Rolling Meadows, IL 60008-3852 Tel: ... NeurosurgeryToday.org Every year, an estimated 11,000 spinal cord injury (SCI) accidents occur in the United States. Motor ...

  6. Retraining the injured spinal cord

    NASA Technical Reports Server (NTRS)

    Edgerton, V. R.; Leon, R. D.; Harkema, S. J.; Hodgson, J. A.; London, N.; Reinkensmeyer, D. J.; Roy, R. R.; Talmadge, R. J.; Tillakaratne, N. J.; Timoszyk, W.; Tobin, A.

    2001-01-01

    The present review presents a series of concepts that may be useful in developing rehabilitative strategies to enhance recovery of posture and locomotion following spinal cord injury. First, the loss of supraspinal input results in a marked change in the functional efficacy of the remaining synapses and neurons of intraspinal and peripheral afferent (dorsal root ganglion) origin. Second, following a complete transection the lumbrosacral spinal cord can recover greater levels of motor performance if it has been exposed to the afferent and intraspinal activation patterns that are associated with standing and stepping. Third, the spinal cord can more readily reacquire the ability to stand and step following spinal cord transection with repetitive exposure to standing and stepping. Fourth, robotic assistive devices can be used to guide the kinematics of the limbs and thus expose the spinal cord to the new normal activity patterns associated with a particular motor task following spinal cord injury. In addition, such robotic assistive devices can provide immediate quantification of the limb kinematics. Fifth, the behavioural and physiological effects of spinal cord transection are reflected in adaptations in most, if not all, neurotransmitter systems in the lumbosacral spinal cord. Evidence is presented that both the GABAergic and glycinergic inhibitory systems are up-regulated following complete spinal cord transection and that step training results in some aspects of these transmitter systems being down-regulated towards control levels. These concepts and observations demonstrate that (a) the spinal cord can interpret complex afferent information and generate the appropriate motor task; and (b) motor ability can be defined to a large degree by training.

  7. Medullary cystic kidney disease

    MedlinePLUS

    ... and diet changes, limiting foods containing phosphorus and potassium. You may need dialysis and a kidney transplant. ... Hyponatremia (low blood sodium level) Hyperkalemia (too much potassium in the blood), especially with end-stage kidney ...

  8. Extraintestinal Complications: Kidney Disorders

    MedlinePLUS

    ... most commonly encountered kidney complications of IBD—particularly oxalate stones. Kidney stones are more common in Crohn's ... of fat malabsorption. Fat binds to calcium, leaving oxalate (a type of salt) free to be absorbed ...

  9. Acute arterial occlusion - kidney

    MedlinePLUS

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  10. Polycystic Kidney Disease

    MedlinePLUS

    ... and requires immediate medical attention. [ Top ] How do health care providers diagnose autosomal dominant polycystic kidney disease? Health ... when test results are available. [ Top ] How do health care providers treat autosomal dominant polycystic kidney disease? Although ...

  11. Testing for Kidney Disease

    MedlinePLUS

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. September 17, 2014​​ Contact Us Health Information Center Phone: 1-800-860- ...

  12. Kidney Replacement Therapy

    MedlinePLUS

    ... a way of cleaning the blood with an artificial kidney. There are two types of dialysis: hemodialysis ... keep diabetes under control. Hemodialysis In hemodialysis, an artificial kidney removes waste from the blood. A surgeon ...

  13. Kidney Disease Risks among Hispanics

    MedlinePLUS

    ... an AKF screening Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... our Northeast Region. Kidney Action Day Kidney Action Day Our late spring event is an elegant fundraiser ...

  14. Sexuality and Chronic Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  15. At Risk for Kidney Disease?

    MedlinePLUS

    ... or organization Alternate Language URL At Risk for Kidney Disease? Page Content You are at risk for ... failure by treating kidney disease early. Diabetes and Kidney Disease Diabetes is the leading cause of kidney ...

  16. Spinal cord and bone metastasizing renal tumor of childhood.

    PubMed

    Arrotegui, J I; Barrios, C

    1995-01-01

    In recent reports on renal tumors of childhood with bone involvement neoplasms originally considered to be Wilms tumor have been assigned to new groups. After reviewing the literature, we knew that Wilms tumor rarely metastasizes in this way. Our case illustrates the unique biological feature of the rare, unfavorable histology Wilms tumor variant know as 'clear cell sarcoma of the kidney' (CCSK). Metastases to the spinal cord, as observed in our patient are distinctly unusual. To our knowledge, only two previous cases have been reported in the world literature. PMID:8556625

  17. Attitudes Towards Individuals with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Conway, Cassandra Sligh D.; Gooden, Randy; Nowell, Jennifer; Wilson, Navodda

    2010-01-01

    This paper will shed light on the lives of persons with spinal cord injuries by revealing the literature on spinal cord injuries that focuses on research that can shed light on attitudes towards persons with spinal cord injuries. The background literature related to incidences, the definition of spinal cord injury, and vocational opportunities are…

  18. Overview of Spinal Cord Disorders

    MedlinePLUS

    ... temperature from the body to the spinal cord. Did You Know... Doctors can often tell where the ... on symptoms and results of a physical examination. Did You Know... Nerves from the lowest parts of ...

  19. [Leiomyosarcoma of the spermatic cord].

    PubMed

    Bertelsen, C A; Jensen, F S

    1996-06-24

    Sarcoma of the spermatic cord is a rare disease with less than 300 cases reported in the literature. A case of leiomyosarcoma is presented, and an analysis of the therapeutic approaches of radical orchidectomy, and in some cases retroperitoneal lymph node dissection, chemotherapy and radiation is given. The total numbers of different types of sarcomas in the spermatic cord, reported to The Danish Department of Cancer Registration are briefly presented as well. PMID:8686076

  20. Dual Kidney Transplant.

    PubMed

    Hassan, Ahmed; Halawa, Ahmed

    2015-12-01

    During the past decades, dual kidney transplant has enabled greater use of marginal kidneys and reduced waiting time. Since the first description of dual transplant in 1996, the techniques and outcomes have improved. No clear allocation criteria for donors and suitable candidates have been outlined; however, in general, an older for older approach is followed by many centers. Many centers are hampered by the lack of a clear allocation policy and the fact that decisions for dual kidney transplant are solely clinician based. Unilateral placement of both kidneys is the technique of choice in many centers. En block pediatric dual transplant and several vascular reconstruction methods for dual kidneys have been adopted by surgeons to enable single arterial and venous anastomosis and to reduce complications. Although there is a higher prevalence of vascular complications, mainly in the form of graft thrombosis, the overall complication rate with dual kidney transplant is comparable to single kidney transplant. Kidney survival and function are encouraging and close to results with standard criteria single kidney transplant. Although the technique is well established in many centers, standardized guidelines are lacking. Here, we review the current experience with dual kidney transplant. PMID:26643671

  1. [New kidney transplants].

    PubMed

    Bergerat, S

    2015-11-01

    Chronic kidney failure and patients that require haemodialysis is increasing, mainly because of the increasing prevalence of diabetic nephropathy. Kidney transplantation is an alternative therapy for chronic renal failure in its terminal stage. Currently, in France and in the world, there is a shortage of kidney transplants. The evolution of the French legislation allows the organ donation from living donor, including awaiting cardiac arrest. PMID:26337224

  2. Papillary Kidney Carcinoma

    Cancer.gov

    The most common type of kidney cancer is called renal cell carcinoma. This cancer forms in the cells lining the small tubules in the kidney that filter waste from the blood and make urine. An estimated 58,240 Americans were expected to have been diagnosed with kidney cancer in 2010 and an estimated 13,040 to have died of this cancer.1 Most people with kidney cancer are usually over 55 years of age and this cancer is more common in men.

  3. Clear Cell Kidney Carcinoma

    Cancer.gov

    The most common type of kidney cancer is called renal cell carcinoma. This cancer forms in the cells lining the small tubules in the kidney that filter waste from the blood and make urine. An estimated 58,240 Americans were expected to have been diagnosed with kidney cancer in 2010 and an estimated 13,040 to have died of this cancer.1 Most people with kidney cancer are usually over 55 years of age and this cancer is more common in men.

  4. HCV and the kidney.

    PubMed

    Corouge, Marion; Vallet-Pichard, Anas; Pol, Stanislas

    2016-01-01

    Chronic hepatitis C (CHC) is significantly associated with a risk of renal deterioration over time. Renal impairment, especially stage 4-5 chronic kidney disease, increases the risk of: (i) the prevalence and incidence (in dialysis/transplantation) of hepatitis C virus (HCV) infection; (ii) liver deterioration during kidney transplantation and (iii) allograft failure and patient mortality. HCV-infected dialysis patients have a higher mortality than non-infected dialysis patients and than HCV-infected kidney recipients. The harmful impact of HCV emphasizes the need for oral antiviral therapies in patients with chronic kidney disease. Symptomatic cryoglobulinemic vasculitis and extensive liver fibrosis are already approved indications for early access to oral antiviral treatment. Patients with stage 4-5 chronic kidney disease should also be given priority: dialysis patients (whatever the stage of fibrosis and whether or not they are candidates for kidney transplantation) as well as all kidney recipients. The results of treatment of HCV with direct-acting antiviral (DAAs) drugs in patients with late chronic kidney disease are excellent, similar to those in the general population, although additional clinical trials are definitely needed, particularly to optimize adjustment of treatment to kidney function and determine the risk of drug-drug interactions. PMID:26725894

  5. Transplant Outcomes (Bone Marrow and Cord Blood)

    MedlinePLUS

    ... reports show patient survival and transplant data of bone marrow and umbilical cord blood transplants in the transplant ... Data by Center Report —View the number of bone marrow and cord blood transplants performed at a specific ...

  6. Management of umbilical cord clamping.

    PubMed

    Webbon, Lucy

    2013-02-01

    The Royal College of Midwives (RCM) has updated its third stage of labour guidelines (RCM 2012) to be clearly supportive of a delay in umbilical cord clamping, although specific guidance on timing is yet to be announced. It is therefore imperative that both midwives and student midwives understand and are able to integrate delaying into their practice, as well as communicating to women the benefits; only in this way can we give women fully informed choices on this aspect of care. The main benefit of delayed cord clamping is the protection it can provide in reducing childhood anaemia, which is a major issue, especially in poorer countries. A review of the evidence found no risks linked to delayed clamping, and no evidence that it cannot be used in combination with the administration of uterotonic drugs. Delayed cord clamping can be especially beneficial for pre term and compromised babies. PMID:23461232

  7. Kidney Surgery Codes

    Cancer.gov

    Kidney, Renal Pelvis, and Ureter Kidney C649, Renal Pelvis C659, Ureter C669 (Except for M9727, 9733, 9741-9742, 9764-9809, 9832, 9840-9931, 9945-9946, 9950-9967, 9975-9992) Codes 00 None; no surgery of primary site; autopsy ONLY 10 Local tumor

  8. Amyloidosis and Kidney Disease

    MedlinePLUS

    ... Foundation Genetic and Rare Diseases Information Center MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... PDF, 345 KB)​​​​​ Alternate Language URL Amyloidosis and Kidney Disease Page Content On this page: What is ...

  9. Keep Your Kidneys Healthy

    MedlinePLUS

    ... Albumin Children and Kidney Disease Additional Kidney Information Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. September 17, 2014​​​​ Contact Us Health Information Center Phone: 1-800-860- ...

  10. Acquired Cystic Kidney Disease

    MedlinePLUS

    ... acquired cystic kidney disease should talk with their health care provider about when to begin screening. [ Top ] Eating, Diet, and Nutrition No specific diet will prevent or delay acquired cystic kidney disease. In general, a diet designed for people on hemodialysis or ...

  11. Trb2, a mouse homolog of tribbles, is dispensable for kidney and mouse development

    SciTech Connect

    Takasato, Minoru; Kobayashi, Chiyoko; Okabayashi, Koji; Kiyonari, Hiroshi; Oshima, Naoko; Asashima, Makoto; Nishinakamura, Ryuichi

    2008-09-05

    Glomeruli comprise an important filtering apparatus in the kidney and are derived from the metanephric mesenchyme. A nuclear protein, Sall1, is expressed in this mesenchyme, and we previously reported that Trb2, a mouse homolog of Drosophila tribbles, is expressed in the mesenchyme-derived tissues of the kidney by microarray analyses using Sall1-GFP knock-in mice. In the present report, we detected Trb2 expression in a variety of organs during gestation, including the kidneys, mesonephros, testes, heart, eyes, thymus, blood vessels, muscle, bones, tongue, spinal cord, and ganglions. In the developing kidney, Trb2 signals were detected in podocytes and the prospective mesangium of the glomeruli, as well as in ureteric bud tips. However, Trb2 mutant mice did not display any apparent phenotypes and no proteinuria was observed, indicating normal glomerular functions. These results suggest that Trb2 plays minimal roles during kidney and mouse development.

  12. Bioengineering Kidneys for Transplantation

    PubMed Central

    Madariaga, Maria Lucia L.; Ott, Harald C.

    2014-01-01

    One in ten Americans suffer from chronic kidney disease, and close to 90,000 people die each year from causes related to kidney failure. Patients with end-stage renal disease are faced with two options: hemodialysis or transplantation. Unfortunately, the reach of transplantation is limited because of the shortage of donor organs and the need for immunosuppression. Bioengineered kidney grafts theoretically present a novel solution to both problems. Herein we discuss the history of bioengineering organs, the current status of bioengineered kidneys, considerations for the future of the field, and challenges to clinical translation. We hope that by integrating principles of tissue engineering, and stem cell and developmental biology, bioengineered kidney grafts will advance the field of regenerative medicine while meeting a critical clinical need. PMID:25217267

  13. [Promoting Living Kidney Transplantation].

    PubMed

    Lin, Chiu-Chu

    2016-04-01

    Kidney transplantation is the best approach for treating patients with end stage renal disease, offering patients the best chance of returning to normal health. While the techniques used in kidney transplantation surgery are mature and highly successful, there is a severe shortage of donor organs. Statistics show a serious imbalance between organ donations and patients on the waiting list for organ transplantation. Moreover, evidence from empirical studies has shown a better transplantation outcome for patients who receive living donor transplantation than for those who receive organs from cadavers. Although using relatives as donors offers an effective way to reduce the problem of organ shortage, this strategy faces many challenges and many other factors affect the promotion of living donor transplantation. This article elaborates how cultural and psychological factors, kidney transplantation awareness, and ethics and laws impact upon living kidney donations and then proposes coping strategies for promoting living kidney transplantation. PMID:27026555

  14. 14 CFR 31.57 - Rip cords.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Rip cords. 31.57 Section 31.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Design Construction 31.57 Rip cords. (a) If a rip cord is used...

  15. 14 CFR 31.57 - Rip cords.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Rip cords. 31.57 Section 31.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Design Construction 31.57 Rip cords. (a) If a rip cord is used...

  16. Psychological Aspects of Spinal Cord Injury

    ERIC Educational Resources Information Center

    Cook, Daniel W.

    1976-01-01

    Reviewing literature on the psychological impact of spinal cord injury suggests: (a) depression may not be a precondition for injury adjustment; (b) many persons sustaining cord injury may have experienced psychological disruption prior to injury; and (c) indexes of rehabilitation success need to be developed for the spinal cord injured. (Author)

  17. Evaluation of spinal cord injury animal models

    PubMed Central

    Zhang, Ning; Fang, Marong; Chen, Haohao; Gou, Fangming; Ding, Mingxing

    2014-01-01

    Because there is no curative treatment for spinal cord injury, establishing an ideal animal model is important to identify injury mechanisms and develop therapies for individuals suffering from spinal cord injuries. In this article, we systematically review and analyze various kinds of animal models of spinal cord injury and assess their advantages and disadvantages for further studies. PMID:25598784

  18. 14 CFR 31.57 - Rip cords.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Rip cords. 31.57 Section 31.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Design Construction 31.57 Rip cords. (a) If a rip cord is used...

  19. 14 CFR 31.57 - Rip cords.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Rip cords. 31.57 Section 31.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Design Construction 31.57 Rip cords. (a) If a rip cord is used...

  20. 14 CFR 31.57 - Rip cords.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Rip cords. 31.57 Section 31.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: MANNED FREE BALLOONS Design Construction 31.57 Rip cords. (a) If a rip cord is used...

  1. Banking on cord blood stem cells.

    PubMed

    Sullivan, Michael J

    2008-07-01

    Umbilical cord blood gifted to non-profit public cord blood banks is now routinely used as an alternative source of haematopoietic stem cells for allogeneic transplantation for children and adults with cancer, bone marrow failure syndromes, haemoglobinopathies and many genetic metabolic disorders. Because of the success and outcomes of public cord banking, many companies now provide private cord banking services. However, in the absence of any published transplant evidence to support autologous and non-directed family banking, commercial cord banks currently offer a superfluous service. PMID:18548085

  2. Tethered cord syndrome: a pediatric case study.

    PubMed

    Greif, L; Stalmasek, V

    1989-04-01

    Tethered cord syndrome, seen in patients with spinal dysraphism, is a progressive neurological deterioration due to stretching of the spinal cord. Spinal dysraphism results from defects during embryonic closure of the neural tube, usually in the lumbosacral region. In tethered cord syndrome an abnormally low conus medullaris is tethered by intradural abnormalities such as a short, thickened filum terminale, fibrous bands, a lipoma or diastematomyelia. This article distinguishes tethered cord syndrome from other forms of occult spinal dysraphism and describes and compares normal anatomy to pathological changes. Clinical symptoms and nursing management of the pediatric patient with tethered cord syndrome will be exemplified by a case study presentation. PMID:2523454

  3. SPINAL CORD INJURY (SCI) DATABASE

    EPA Science Inventory

    The National Spinal Cord Injury Database has been in existence since 1973 and captures data from SCI cases in the United States. Since its inception, 24 federally funded Model SCI Care Systems have contributed data to the National SCI Database. Statistics are derived from this da...

  4. Keep Your Kidneys Healthy: Catch Kidney Disease Early

    MedlinePLUS

    ... please review our exit disclaimer . Subscribe Keep Your Kidneys Healthy Catch Kidney Disease Early Your kidneys aren’t very big—each is about the ... other substances inside your body. Unfortunately, if your kidneys start to malfunction, you might not realize it ...

  5. National Kidney and Urologic Diseases Information Clearinghouse

    MedlinePLUS

    ... V iew personal stories .??? Alternate Language URL Espaol Kidney Disease A-Z Page Content Kidney disease topics ... lead to chronic kidney disease Anatomy of the Kidneys The Kidneys and How They Work Anemia and ...

  6. What Is Kidney Cancer (Renal Cell Carcinoma)?

    MedlinePLUS

    ... the key statistics about kidney cancer? What is kidney cancer? Kidney cancer is a cancer that starts ... and spread, see What Is Cancer? About the kidneys To understand more about kidney cancer, it helps ...

  7. Newborn cord care practices in Haiti.

    PubMed

    Walsh, Susan; Norr, Kathleen; Sankar, Girija; Sipsma, Heather

    2015-10-01

    Newborn cord infections commonly lead to neonatal sepsis and death, particularly in low-resource countries where newborns may receive unhygienic cord care. Topical application of chlorhexidine to the newborn's cord has been shown to prevent infection. Such benefits may be particularly important in Haiti. We explored current cord care practices by conducting a qualitative study using five focus groups among key community stakeholders (mothers of newborns/children under age two years, pregnant women, traditional birth attendants, community health workers, traditional healers) in Petit-Gove, Haiti. Data collection was guided by the Health Belief Model. Results suggest community stakeholders recognise that infants are susceptible to cord infection and that cord infection is a serious threat to newborns. Long-held traditional cord care practices are potential barriers to adopting a new cord care intervention. However, all groups acknowledged that traditional practices could be harmful to the newborn while expressing a willingness to adopt practices that would protect the newborn. Results demonstrate potential acceptability for altering traditional cord care practices among neonatal caretakers in Haiti. An informational campaign designed to educate local health workers and new mothers to eliminate unhygienic cord applications while promoting chlorhexidine application may be a strong approach for preventing neonatal cord infections. PMID:25727359

  8. Umbilical cord blood: information for childbirth educators.

    PubMed

    Waller-Wise, Renece

    2011-01-01

    Umbilical cord blood was once thought of as a waste product. Now, years after the first successful umbilical cord blood transplant, more families seek information about whether or not to save their newborn's cord blood. Childbirth educators may be one of the main sources that an expectant family depends on to gain more knowledge about cord blood banking in order to make an informed decision. Preserving umbilical cord blood in public banks is advisable for any family; however, it is recommended that expectant families only consider private cord blood banking when they have a relative with a known disorder that is treatable by stem cell transplants. The childbirth educator is encouraged to be well versed on the topic of cord blood banking, so that as questions from class participants arise, the topic can be explored and addressed appropriately. PMID:22211060

  9. HIV and Kidney Disease

    MedlinePLUS

    ... remove the waste in urine. The most important waste products are excess sodium and water. . Each kidney contains about a million filtering units called nephrons. They: eliminate wastes from the body, regulate the volume and pressure ...

  10. Organ Facts: Kidney / Pancreas

    MedlinePLUS

    ... the kidneys is to remove waste from the body through the production of urine. They also help to regulate blood pressure, blood volume and the chemical (electrolyte) composition of the blood. The pancreas is a five ...

  11. Living with Kidney Cancer

    MedlinePLUS

    ... Trials Find A Clinical Trial (EmergingMed) A Patient’s Perspective Live Living With Kidney Cancer Cancer Nutrition Information ( ... Second, many insurance companies have formal claims appeal processes. You can appeal your claim and have it ...

  12. Kidney Disease of Diabetes

    MedlinePLUS

    ... is the most common cause of kidney failure, accounting for nearly 44 percent of new cases. 1 ... health care provider regarding insulin injections, medicines, meal planning, physical activity, and blood glucose monitoring. have their ...

  13. Diabetes and Kidney Disease

    MedlinePLUS

    ... NKF Newsroom Contact Us You are here Home » Diabetes - A Major Risk Factor for Kidney Disease Diabetes ... of your body. Are there different types of diabetes? The most common ones are Type 1 and ...

  14. Kidney Disease and Diabetes

    MedlinePLUS

    ... Blood Pressure Tools & Resources Stroke More Kidney Disease & Diabetes Updated:Jan 26,2016 One of the more ... thereafter.) This content was last reviewed January 2016. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  15. Sulfadiazine for kidney disease

    USGS Publications Warehouse

    Rucker, R.R.; Bernier, A.F.; Whipple, W.J.; Burrows, R.E.

    1951-01-01

    The blueback salmon fingerlings (Oncorhynchus nerka) at the U.S. Fish-Cultural Station at Winthrop, Washington, underwent an infection that was caused by a very short, Gram-positive, nonmotile, rod-shaped bacterium. A further description is impossible at this time, as the organism has not been grown satisfactorily for proper identification. The disease was characterized by white, raised areas of dead tissue mainly in the kidney: for this reason it is referred to as kidney disease. Belding and Merrill (1935) described a disease among the brook, brown, and rainbow trout at a State hatchery in Massachusetts which, from the description, might be the same as kidney disease. J.H. Wales of the California Division of Fish and Game described (unpublished manuscript, 1941) a disease in hatchery trout in California which seems to be identical to kidney disease.

  16. Kidney Stones (For Parents)

    MedlinePLUS

    ... can develop in the urinary tract . Also called calculi or nephrolithiasis, kidney stones form when salts and ... form a stone. Struvite stones: Also called staghorn calculi because they look like a stag's antlers, these ...

  17. Medicines and Kidney Disease

    MedlinePLUS

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. ​​September 17, 2014 Contact Us Health Information Center Phone: 1-800-860- ...

  18. Unusual drainage of the main kidney on accessory kidney

    PubMed Central

    Erdem, Glnur; U?ra?, Murat; Demirz, Sevgi

    2014-01-01

    Patients with an accessory kidney are characterized by an excessive number of kidneys. The ureter of the accessory kidney either drains separately into the bladder or merges with the ureter of the main kidney. In our case, interestingly, the ureter of the left main kidney drained directly into the accessory kidney and the ureter of the latter was the common drainage route for both. The drainage of a normal kidney via the ureter of an accessory kidney has not been reported in the literature, so far. The aim of this report is to present the case with radiological findings and to emphasize the effects of this situation on planned surgical procedures. A 62-year-old female patient had an interesting abnormality on the left collecting system, which was revealed on excretory urography (EU), retrograde urography (RU) and multidetector computed tomography (MDCT). A kinky left ureter, which formed a U shape, was revealed on EU. On MDCT, an accessory kidney was revealed at the anterior aspect of the middle zone of left main kidney. The ureter of the main left kidney drained directly into the accessory kidney. The course of this drainage was confirmed by retrograde urography. An accessory kidney is a rare entity associated with horseshoe kidney, ectopic ureter draining into the vagina, bifid collecting system and coarctation of the aorta. In our case, an unusual association between the ureters of the main and accessory kidneys was revealed, which may have an impact on planned surgery in the groin and retroperitoneal areas. PMID:26328163

  19. Kidney cell electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P. W.

    1985-01-01

    Tasks were undertaken in support of two objectives. They are: (1) to carry out electrophoresis experiments on cells in microgravity; and (2) assess the feasibility of using purified kidney cells from embryonic kidney cultures as a source of important cell products. Investigations were carried out in the following areas: (1) ground based electrophoresis technology; (2) cell culture technology; (3) electrophoresis of cells; (4) urokinase assay research; (5) zero-g electrophoresis; and (6) flow cytometry.

  20. Signaling during Kidney Development

    PubMed Central

    Krause, Mirja; Rak-Raszewska, Aleksandra; Pietilä, Ilkka; Quaggin, Susan E.; Vainio, Seppo

    2015-01-01

    The kidney plays an essential role during excretion of metabolic waste products, maintenance of key homeostasis components such as ion concentrations and hormone levels. It influences the blood pressure, composition and volume. The kidney tubule system is composed of two distinct cell populations: the nephrons forming the filtering units and the collecting duct system derived from the ureteric bud. Nephrons are composed of glomeruli that filter the blood to the Bowman’s capsule and tubular structures that reabsorb and concentrate primary urine. The collecting duct is a Wolffian duct-derived epithelial tube that concentrates and collects urine and transfers it via the renal pelvis into the bladder. The mammalian kidney function depends on the coordinated development of specific cell types within a precise architectural framework. Due to the availability of modern analysis techniques, the kidney has become a model organ defining the paradigm to study organogenesis. As kidney diseases are a problem worldwide, the understanding of mammalian kidney cells is of crucial importance to develop diagnostic tools and novel therapies. This review focuses on how the pattern of renal development is generated, how the inductive signals are regulated and what are their effects on proliferation, differentiation and morphogenesis. PMID:25867084

  1. Ganglioglioma of the Spinal Cord

    PubMed Central

    Oppenheimer, Daniel C; Johnson, Mahlon D; Judkins, Alexander R

    2015-01-01

    Ganglioglioma is a rare tumor consisting of neoplastic glial and neuronal elements. It accounts for only 0.5% of all primary central nervous system (CNS) neoplasms. We report an unusual case of extensive intramedullary thoracic spinal cord ganglioglioma in a 14-month-old girl who underwent subtotal resection followed by adjuvant chemotherapy. The epidemiology, histopathologic features, imaging findings, treatment, and prognosis are subsequently reviewed. PMID:26605127

  2. An Ectopic Pelvic Kidney

    PubMed Central

    Bhoil, Rohit; Sood, Dinesh; Singh, Yash Paul; Nimkar, Kshama; Shukla, Anurag

    2015-01-01

    Summary Background If a kidney does not ascend as it should in normal fetal development, it remains in the pelvic area and is called a pelvic kidney. Often a person with a pelvic kidney will go through his/her whole life unaware of this condition, unless it is discovered during neonatal kidney ultrasound screening or if complications arise later in life due to this or a completely different reason and the condition is noted during investigations. Generally, this is not a harmful condition but it can lead to complications like in our case. With appropriate testing and treatment, if needed, an ectopic kidney should cause no serious long-term health complications and all that may be required for the patient is reassurance with advice to follow up at regular intervals. Case Report A 28-year-old male presented with recurrent pain in his lower left abdomen for one month and an episode of hematuria 3 days earlier accompanied by an attack of acute pain lasting for 34 hours. He gave a history of passing 2 small (about 5 mm each) calculi in his urine after the occurrence of hematuria, following which pain decreased in intensity. No history of fever was present. Conclusions Although a simple ectopic kidney seldom causes symptoms, the association of malrotation of the renal pelvis with calculus increases the risk of hematuria and/or hydronephrosis, presenting with colicky pain as in the present case. The clinician should be aware of these in such a case. If asymptomatic, no treatment is required. However, the patient should be advised to have follow-up ultrasounds at regular intervals to detect complications like calculus, hydronephrosis, etc. With appropriate testing and treatment, if required, an ectopic kidney should not cause serious long-term health complications. PMID:26413178

  3. Pregnancy following spinal cord injury.

    PubMed Central

    Cross, L. L.; Meythaler, J. M.; Tuel, S. M.; Cross, A. L.

    1991-01-01

    Each year about 2,000 women of childbearing age in the United States have a spinal cord injury. Only a few mostly anecdotal reports describe pregnancy after such an injury. In a retrospective study of 16 women with a spinal cord injury, half of whom have a complete injury and about half quadriplegia, 25 pregnancies occurred, with 21 carried to full term. The women delayed pregnancy an average of 6.5 years after their injury, with an average age at first pregnancy of 26.8 years. Cesarean section was necessary in 4 patients because of inadequate progress of labor. In 5 deliveries an episiotomy and local anesthesia were required, 7 required epidural anesthesia, including all cesarean sections, and 10 did not require anesthesia. Several complications have been identified in the antepartum, intrapartum, and postpartum periods including autonomic hyperreflexia, premature labor, pressure sores, urinary tract infections, abnormal presentation, and failure to progress. Ultrasonography and amniocentesis were used selectively. Women with spinal cord injuries can have healthy children, although there are significant risks and these women have special needs. PMID:1866960

  4. Religious perspectives on umbilical cord blood banking.

    PubMed

    Jordens, Christopher F C; O'Connor, Michelle A C; Kerridge, Ian H; Stewart, Cameron; Cameron, Andrew; Keown, Damien; Lawrence, Rabbi Jeremy; McGarrity, Andrew; Sachedina, Abdulaziz; Tobin, Bernadette

    2012-03-01

    Umbilical cord blood is a valuable source of haematopoietic stem cells. There is little information about whether religious affiliations have any bearing on attitudes to and decisions about its collection, donation and storage. The authors provided information about umbilical cord blood banking to expert commentators from six major world religions (Catholicism, Anglicanism, Islam, Judaism, Hinduism and Buddhism) and asked them to address a specific set of questions in a commentary. The commentaries suggest there is considerable support for umbilical cord blood banking in these religions. Four commentaries provide moral grounds for favouring public donation over private storage. None attach any particular religious significance to the umbilical cord or to the blood within it, nor place restrictions on the ethnicity or religion of donors and recipients. Views on ownership of umbilical cord blood vary. The authors offer a series of general points for those who seek a better understanding of religious perspectives on umbilical cord blood banking. PMID:22558902

  5. [EVALUATION OF RENAL FUNCTION IN PATIENTS WITH SPINAL CORD INJURY].

    PubMed

    Shchurova, E N; Stogov, M V; Dyachkova, G V

    2015-01-01

    A comprehensive evaluation of renal function in 59 patients with spinal cord injury was performed. Excretory urography, biochemical and ion-selective analysis of serum and daily urine were used. Excretory urography had showed a reduction in the cumulative and excretory renal functions, which was accompanied by an increase in glomerular filtration rate, regardless of the level of damage and the period of traumatic disease. Excretory renal function has undergone a number of changes: 1) decrease in clearance of nitrogenous components; 2) an increase in clearance of mineral components in acute phase; 3) decrease in the rate of calcium excretion. Spinal cord injury contributed to an increase in the stimulating effect of aldosterone on the distal tubules of nephrons function of the kidneys, manifested in the form of increased excretion of potassium in the urine. In case of injury of the cervical and thoracic spine, significant increase in the K/Na coefficient was determined in acute phase, in patients with lumbar spine injury - in the late period. PMID:26094382

  6. Necroinflammation in Kidney Disease.

    PubMed

    Mulay, Shrikant R; Linkermann, Andreas; Anders, Hans-Joachim

    2016-01-01

    The bidirectional causality between kidney injury and inflammation remains an area of unexpected discoveries. The last decade unraveled the molecular mechanisms of sterile inflammation, which established danger signaling via pattern recognition receptors as a new concept of kidney injury-related inflammation. In contrast, renal cell necrosis remained considered a passive process executed either by the complement-related membrane attack complex, exotoxins, or cytotoxic T cells. Accumulating data now suggest that renal cell necrosis is a genetically determined and regulated process involving specific outside-in signaling pathways. These findings support a unifying theory in which kidney injury and inflammation are reciprocally enhanced in an autoamplification loop, referred to here as necroinflammation. This integrated concept is of potential clinical importance because it offers numerous innovative molecular targets for limiting kidney injury by blocking cell death, inflammation, or both. Here, the contribution of necroinflammation to AKI is discussed in thrombotic microangiopathies, necrotizing and crescentic GN, acute tubular necrosis, and infective pyelonephritis or sepsis. Potential new avenues are further discussed for abrogating necroinflammation-related kidney injury, and questions and strategies are listed for further exploration in this evolving field. PMID:26334031

  7. Horseshoe kidney transplantation

    PubMed Central

    Kanyri, Zsolt; Zdori, Gergely; Zsom, Lajos; Berhs, Mariann; Hamar, Mtys; Kbor, Krisztina; Pter, Antal

    2015-01-01

    Horseshoe kidney is a fusion anomaly found in approximately one in 400600 people. Due to vascular and ureteral variations, transplantation with a horseshoe kidney presents a technical challenge. In our case, the isthmus connected the upper poles and contained parenchyma. It consisted of three renal arteries, five veins collected to the inferior vena cava, and two ureters and pyelons. It was implanted en bloc to the left side retroperitoneally. During the early period, cellular and humoral rejection was confirmed and treated. For a urine leak, double J catheters were implanted into both ureters. Later, the first catheter was removed. Subsequently, urinary sepsis developed, necessitating graftectomy. The uncommon anatomy of ureters and antibody-mediated rejection (AMR) may both be factors for a ureter tip necrosis led to an infected urinoma. After other Hungarian authors, we also report a horseshoe kidney transplantation that was technically successful. However, after an adequately treated but severe acute humoral rejection, the patient developed sepsis, and the kidney had to be removed. We conclude that transplantation with horseshoe kidney is technically feasible but may increase the risk for urinary complications and resultant infections. Careful consideration of risk and benefit is advised when a transplant professional is faced with this option. PMID:26120481

  8. Kidney Failure - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... Arabic (???????) Kidney Failure (Arabic) ????? ?????? - ??????? Bilingual PDF Health Information Translations Bosnian (Bosanski) Kidney Failure Otkazivanje rada bubrega - Bosanski (Bosnian) Bilingual PDF Health Information Translations Chinese - Simplified (????) Kidney ...

  9. Cord blood banking for potential future transplantation.

    PubMed

    Lubin, Bertram H; Shearer, William T

    2007-01-01

    In recent years, umbilical cord blood, which contains a rich source of hematopoietic stem and progenitor cells, has been used successfully as an alternative allogeneic donor source to treat a variety of pediatric genetic, hematologic, immunologic, and oncologic disorders. Because there is diminished risk of graft-versus-host disease after transplantation of cord stem cells using matched related donors, the use of less-than-completely matched HLA cord blood stem cells may incur less risk of graft-versus-host disease than mismatched cells from either a related or unrelated "walking" donor, although this remains to be proven. Gene-therapy research involving modification of autologous cord blood stem cells for the treatment of childhood genetic disorders, although experimental at the present time, may prove to be of value. These scientific advances have resulted in the establishment of not-for-profit and for-profit cord blood-banking programs for allogeneic and autologous cord blood transplantation. Many issues confront institutions that wish to establish or participate in such programs. Parents often seek information from their physicians about this new biotechnology option. This document is intended to provide information to guide physicians in responding to parents' questions about cord blood donation and banking and the types and quality of cord blood banks. Provided also are recommendations about appropriate ethical and operational standards, including informed consent policies, financial disclosures, and conflict-of-interest policies for physicians, institutions, and organizations that operate or have a relationship with cord blood-banking programs. PMID:17200285

  10. Therapeutic approaches for spinal cord injury

    PubMed Central

    Cristante, Alexandre Fogaa; de Barros Filho, Tarcsio Eloy Pessoa; Marcon, Raphael Martus; Letaif, Olavo Biraghi; da Rocha, Ivan Dias

    2012-01-01

    This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a disease that should not be treated. Over the last two decades, several studies have been performed to obtain more effective treatments for spinal cord injury. Most of these studies approach a patient with acute spinal cord injury in one of four manners: corrective surgery or a physical, biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life. PMID:23070351

  11. How Are Brain and Spinal Cord Tumors in Children Diagnosed?

    MedlinePLUS

    ... spinal cord tumors in children staged? How are brain and spinal cord tumors diagnosed in children? Brain ... resonance angiography (MRA) or computerized tomographic angiography (CTA). Brain or spinal cord tumor biopsy Imaging tests such ...

  12. Testosterone Plus Finasteride Treatment After Spinal Cord Injury

    ClinicalTrials.gov

    2016-01-29

    Spinal Cord Injury; Spinal Cord Injuries; Trauma, Nervous System; Wounds and Injuries; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Diseases; Gonadal Disorders; Endocrine System Diseases; Hypogonadism; Genital Diseases, Male

  13. Brainkidney crosstalk

    PubMed Central

    2014-01-01

    Encephalopathy and altered higher mental functions are common clinical complications of acute kidney injury. Although sepsis is a major triggering factor, acute kidney injury predisposes to confusion by causing generalised inflammation, leading to increased permeability of the bloodbrain barrier, exacerbated by hyperosmolarity and metabolic acidosis due to the retention of products of nitrogen metabolism potentially resulting in increased brain water content. Downregulation of cell membrane transporters predisposes to alterations in neurotransmitter secretion and uptake, coupled with drug accumulation increasing the risk of encephalopathy. On the other hand, acute brain injury can induce a variety of changes in renal function ranging from altered function and electrolyte imbalances to inflammatory changes in brain death kidney donors. PMID:25043644

  14. Diet for Kidney Stone Prevention

    MedlinePLUS

    ... may also help prevent kidney stones, such as citrus drinks. Recommendations based on the specific type of ... do to prevent kidney stones. Some studies suggest citrus drinks like lemonade and orange juice protect against ...

  15. Renal (Kidney) Manifestations in TSC

    MedlinePLUS Videos and Cool Tools

    ... TSC Research Conference Text Size Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of this ... complex (TSC) will develop some form of renal (kidney) disease during their lifetime. There are three particular ...

  16. Kidney Stone Treatment with Lithotripsy

    MedlinePLUS Videos and Cool Tools

    Kidney Stone Treatment with Lithotripsy Broward Health Medical Center Fort Lauderdale, FL November 11, 2011 I'm ... got at least three stones in his left kidney. He's been having pain and blood in his ...

  17. Chronic Kidney Disease and Medicines

    MedlinePLUS

    ... Alternate Language URL Español Chronic Kidney Disease and Medicines: What You Need to Know Page Content What ... pharmacist and provider need to know about your medicine and supplement use Your kidneys do not filter ...

  18. Kidney Failure and Vascular Disease

    MedlinePLUS

    ... with renal failure can be treated with an artificial kidney machine (dialysis) which removes toxins from the blood. Patients requiring ongoing dialysis use the artificial kidney machine up to three times a week ...

  19. [Potential biochemical factors for the development of urolithiasis in patients with spinal cord injuries].

    PubMed

    Stogov, M V; Shchurova, E N; Bliudenov, D N

    2014-01-01

    A comparative analysis of biochemical parameters of blood serum and daily urine in patients with urolithiasis developed after spinal cord injury (study group--35 patients) and patients without development of the disease (comparison group--20 patients) was performed. It was found that patients after spinal cord injury have developed productive azotemia, which led to the disruption of renal excretory function (accumulation of urea and creatinine in blood, and lowering their clearance). Against this background, there is violation of excretion of uric acid, magnesium, decreased sensitivity of the renal tubules to aldosterone (in patients with nephrolithiasis K/Na ratio in urine was lower). As a result, patients have decreased reabsorption of sodium and water retention, increased urine osmolality; against the background of electrolyte imbalance in urine, this leads to the formation of stones. In patients with spinal cord injuries, main trigger mechanism of formation of urinary stones was excessive posttraumatic azotemia. The high concentration of the products of protein-nitrogen catabolism in the serum of patients in the acute and early periods of spinal cord injury may be unfavorable criterion determining the significant risk of developing of kidney stones. PMID:24772768

  20. Kidney Disease Risks among African-Americans

    MedlinePLUS

    ... an AKF screening Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... our Northeast Region. Kidney Action Day Kidney Action Day Our late spring event is an elegant fundraiser ...

  1. You, Your Blood Pressure, and Your Kidneys

    MedlinePLUS

    ... an AKF screening Kidney Action Day Kidney Action Day Learn about our signature outreach event. About AKF ... our Northeast Region. Kidney Action Day Kidney Action Day Our late spring event is an elegant fundraiser ...

  2. When Your Child Needs a Kidney Transplant

    MedlinePLUS

    ... for Your Child When Your Child Needs a Kidney Transplant KidsHealth > For Parents > When Your Child Needs ... to monitor their new kidney function. About the Kidneys Kidneys are bean-shaped organs located near the ...

  3. Vitamins and Minerals in Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  4. Lupus and Kidney Disease (Lupus Nephritis)

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  5. Working with Kidney Disease: Rehabilitation and Employment

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  6. When Your Child Needs a Kidney Transplant

    MedlinePLUS

    ... About Food Allergies When Your Child Needs a Kidney Transplant KidsHealth > For Parents > When Your Child Needs ... to monitor their new kidney function. About the Kidneys Kidneys are bean-shaped organs located near the ...

  7. Kidney stones - what to ask your doctor

    MedlinePLUS

    A kidney stone is a solid piece of material that forms in your kidney. The kidney stone may be stuck in your ureter (the tube that carries urine from your kidneys to your bladder). It also may be stuck ...

  8. Recognising metastatic spinal cord compression.

    PubMed

    Bowers, Ben

    2015-04-01

    Metastatic spinal cord compression (MSCC) is a potentially life changing oncological emergency. Neurological function and quality of life can be preserved if patients receive an early diagnosis and rapid access to acute interventions to prevent or reduce nerve damage. Symptoms include developing spinal pain, numbness or weakness in arms or legs, or unexplained changes in bladder and bowel function. Community nurses are well placed to pick up on the 'red flag' symptoms of MSCC and ensure patients access prompt, timely investigations to minimise damage. PMID:25839873

  9. Kidney Stones (For Parents)

    MedlinePLUS

    ... in urine (pee) become extra concentrated and form crystals. Over a few weeks or months, the crystals can build up and become stones. Kidney stones ... changes the level of a substance in it, crystals can begin to form. The crystals can become ...

  10. Chronic Kidney Disease

    MedlinePLUS

    ... The most common causes of CKD are high blood pressure, diabetes and heart disease. Chronic kidney disease can also ... healthy diet can also help to lower your blood pressure. If you have diabetes, your doctor will tell you what to do ...

  11. Monitoring Your Kidney Health

    MedlinePLUS

    ... Dialysis or Transplant Paying for Kidney Failure Treatment Contact Us Health Information Center Phone: 1-800-860- ... to share this content freely. ​​September 17, 2014​​ Contact Us Health Information Center Phone: 1-800-860- ...

  12. Diet - chronic kidney disease

    MedlinePLUS

    ... the sodium in your diet. Look for these words on food labels: Low-sodium No salt added Sodium-free Sodium-reduced Unsalted Check ... much potassium can build up when the kidneys no longer function ... is found in many food groups, including fruits and vegetables. ...

  13. Pain Management Following Spinal Cord Injury

    MedlinePLUS

    ... M anagement following S pinal C ord I njury Spinal Cord Injury InfoSheet 10 Level - Consumer W HAT IS P ... after the body heals. Research on pain following spinal cord injury is very complicated. Not only are there several ...

  14. How Is Spinal Cord Injury (SCI) Diagnosed?

    MedlinePLUS

    ... National Institute of Neurological Disorders and Stroke. (2012). Spinal cord injury: Hope through research . Retrieved June 26, 2012, from ... sci.htm [top] University Specialty Clinics. (n.d.). Spinal cord injury . Retrieved June 26, 2012, from http://neurosurgery.med. ...

  15. Spinal Cord Injury Model System Information Network

    MedlinePLUS

    ... the UAB-SCIMS Contact the UAB-SCIMS UAB Spinal Cord Injury Model System Newly Injured Health Daily Living Consumer ... Information Network The University of Alabama at Birmingham Spinal Cord Injury Model System (UAB-SCIMS) maintains this Information Network ...

  16. Nutrition of People with Spinal Cord Injuries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This conference proceeding summarizes current knowledge about the nutritional status and needs of the spinal cord injured patient. Topics covered include the aspects of spinal cord injury that influence nutrient intakes and status, and the nutrients most likely to be problematic in this diverse gro...

  17. Neonatal umbilical cord myiasis in New Jersey.

    PubMed

    Puvabanditsin, S; Malik, I; Weidner, L M; Jadhav, S; Sanderman, J; Mehta, R

    2014-09-01

    Human myiasis is a rare condition. It is more common in tropical regions. Umbilical cord myiasis has not previously been reported from a temperate climate, for example, New Jersey. We report a 9-day-old infant with umbilical cord myiasis. The maggots were identified by the entomologist as the larvae of Sarcophagidae, more commonly known as flesh flies. PMID:25179383

  18. Family-directed umbilical cord blood banking.

    PubMed

    Gluckman, Eliane; Ruggeri, Annalisa; Rocha, Vanderson; Baudoux, Etienne; Boo, Michael; Kurtzberg, Joanne; Welte, Kathy; Navarrete, Cristina; van Walraven, Suzanna M

    2011-11-01

    Umbilical cord blood transplantation from HLA-identical siblings provides good results in children. These results support targeted efforts to bank family cord blood units that can be used for a sibling diagnosed with a disease which can be cured by allogeneic hematopoietic stem cell transplantation or for research that investigates the use of allogeneic or autologous cord blood cells. Over 500 patients transplanted with related cord blood units have been reported to the Eurocord registry with a 4-year overall survival of 91% for patients with non-malignant diseases and 56% for patients with malignant diseases. Main hematologic indications in children are leukemia, hemoglobinopathies or inherited hematologic, immunological or metabolic disorders. However, family-directed cord blood banking is not widely promoted; many cord blood units used in sibling transplantation have been obtained from private banks that do not meet the necessary criteria required to store these units. Marketing by private banks who predominantly store autologous cord blood units has created public confusion. There are very few current validated indications for autologous storage but some new indications might appear in the future. Little effort is devoted to provide unbiased information and to educate the public as to the distinction between the different types of banking, economic models and standards involved in such programs. In order to provide a better service for families in need, directed-family cord blood banking activities should be encouraged and closely monitored with common standards, and better information on current and future indications should be made available. PMID:21750089

  19. Childhood Obesity Research Demonstration (CORD): Evaluation plan

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Childhood Obesity Research Demonstration (CORD) project evaluation will determine the extent to which the CORD model of linking primary care (PC) interventions to public health (PH) interventions in multiple community sectors affects BMI and behavior in children (2 to 12 years). The evaluation c...

  20. Family-directed umbilical cord blood banking

    PubMed Central

    Gluckman, Eliane; Ruggeri, Annalisa; Rocha, Vanderson; Baudoux, Etienne; Boo, Michael; Kurtzberg, Joanne; Welte, Kathy; Navarrete, Cristina; van Walraven, Suzanna M.

    2011-01-01

    Umbilical cord blood transplantation from HLA-identical siblings provides good results in children. These results support targeted efforts to bank family cord blood units that can be used for a sibling diagnosed with a disease which can be cured by allogeneic hematopoietic stem cell transplantation or for research that investigates the use of allogeneic or autologous cord blood cells. Over 500 patients transplanted with related cord blood units have been reported to the Eurocord registry with a 4-year overall survival of 91% for patients with non-malignant diseases and 56% for patients with malignant diseases. Main hematologic indications in children are leukemia, hemoglobinopathies or inherited hematologic, immunological or metabolic disorders. However, family-directed cord blood banking is not widely promoted; many cord blood units used in sibling transplantation have been obtained from private banks that do not meet the necessary criteria required to store these units. Marketing by private banks who predominantly store autologous cord blood units has created public confusion. There are very few current validated indications for autologous storage but some new indications might appear in the future. Little effort is devoted to provide unbiased information and to educate the public as to the distinction between the different types of banking, economic models and standards involved in such programs. In order to provide a better service for families in need, directed-family cord blood banking activities should be encouraged and closely monitored with common standards, and better information on current and future indications should be made available. PMID:21750089

  1. Kidneys and How They Work

    MedlinePLUS

    ... Options National Kidney Foundation The NephCure Foundation MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... PDF, 345 KB) Alternate Language URL Español The Kidneys and How They Work Page Content On this ...

  2. Kidney Failure: What to Expect

    MedlinePLUS

    ... Fund National Kidney Foundation Renal Support Network MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Organizations​​ . (PDF, 345 KB)​​​​​ Alternate Language URL Español Kidney Failure: What to Expect Page Content On this ...

  3. Anemia in Chronic Kidney Disease

    MedlinePLUS

    ... Kidney Foundation U.S. Food and Drug Administration MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... 345 KB)​​​​​ Alternate Language URL Anemia in Chronic Kidney Disease Page Content On this page: What is ...

  4. History of the spinal cord localization.

    PubMed

    Naderi, Sait; Tre, U?ur; Pait, T Glenn

    2004-01-15

    The first reference to spinal cord injury is recorded in the Edwin Smith papyrus. Little was known of the function of the cord before Galen's experiments conducted in the second century AD. Galen described the protective coverings of the spinal cord: the bone, posterior longitudinal ligament, dura mater, and pia mater. He gave a detailed account of the gross anatomy of the spinal cord. During the medieval period (AD 700-1500) almost nothing of note was added to Galen's account of spinal cord structure. The first significant work on the spinal cord was that of Blasius in 1666. He was the first to differentiate the gray and white matter of the cord and demonstrated for the first time the origin of the anterior and posterior spinal nerve roots. The elucidation of the various tracts in the spinal cord actually began with demonstrations of pyramidal decussation by Mistichelli (1709) and Pourfoir du Petit (1710). Huber (1739) recorded the first detailed account of spinal roots and the denticulate ligaments. In 1809, Rolando described the substantia gelatinosa. The microtome, invented in 1824 by Stilling, proved to be one of the fundamental tools for the study of spinal cord anatomy. Stilling's technique involved slicing frozen or alcohol-hardened spinal cord into very thin sections and examining them unstained by using the naked eye or a microscope. With improvements in histological and experimental techniques, modern studies of spinal cord anatomy and function were initiated by Brown-Sequard. In 1846, he gave the first demonstration of the decussation of the sensory tracts. The location and direction of fiber tracts were uncovered by the experimental studies of Burdach (1826), Turck (1849), Clarke (1851), Lissauer (1855), Goll (1860), Flechsig (1876), and Gowers (1880). Bastian (1890) demonstrated that in complete transverse lesions of the spinal cord, reflexes below the level of the lesion are lost and muscle tone is abolished. Flatau (1894) observed the laminar nature of spinal pathways. The 20th century ushered in a new era in the evaluation of spinal cord function and localization; however, the total understanding of this remarkable organ remains elusive. Perhaps the next century will provide the answers to today's questions about spinal cord localization. PMID:15264793

  5. Use of Umbilical Cord Serum in Ophthalmology

    PubMed Central

    2014-01-01

    Among blood preparations, serum has been topically used in the management of various ocular diseases in ophthalmology. Like peripheral blood serum, umbilical cord blood serum contains a high concentration of essential tear components, growth factors, neurotrophic factors, vitamin A, fibronectin, prealbumin, and oil. Umbilical cord serum can provide basic nutrients for epithelial renewal and can facilitate the proliferation, migration, and differentiation of the ocular surface epithelium. Eye drops made from umbilical cord serum have been applied to treat various ocular surface diseases, including severe dry eye with or without Sjgren's syndrome, ocular complications in graft-versus-host disease, persistent epithelial defects, neurotrophic keratopathy, recurrent corneal erosions, ocular chemical burn, and surface problems after corneal refractive surgery. Because mesenchymal stem cells from umbilical cord blood can be used to regenerate corneal tissue and retinal nerve cells, umbilical cord serum might be applied for tissue engineering and regenerative medicine in the future. PMID:25568842

  6. Recording of cord dorsum potentials in calves.

    PubMed

    Van Soens, I; De Vlamynck, C; Pille, F; Vlaminck, L; Duchateau, L; Van Ham, L

    2015-10-01

    Cord dorsum potentials are sensory evoked potentials being used to assess proximal sensory nerve, dorsal nerve root and spinal cord dorsal horn function. The purpose of the present study was to establish normal values for onset latency, peak latency and peak-to-peak amplitude of cord dorsum potentials after saphenous nerve stimulation in 15 healthy calves. Under general anesthesia, the saphenous nerve was stimulated in the periphery and cord dorsum potentials were recorded from the interarcuate space L3-L4, L4-L5, L5-L6 and L6-S1. Cord dorsum potentials were easily recorded at the different recording sites and consisted of a large negative peak followed by a long latency positive phase. The largest responses were recorded at the L5-L6 interarcuate space. Body temperature significantly influenced peak-to-peak amplitude. Onset latency prolonged with increasing limb length. PMID:26412527

  7. Kidney Size Comparison of BEN Victims

    USGS Multimedia Gallery

    Normal size kidney (left) and a Balkan endemic nephropathy (BEN) kidney (right). The BEN kidney is reduced by one third compared to a normal kidney. The collapse of the kidney structure in the BEN kidney causes the organ to cease to function, resulting in uremia (blood poisoning) and requiring dialy...

  8. Rehabilitation of spinal cord injuries

    PubMed Central

    Nas, Kemal; Yazmalar, Levent; Şah, Volkan; Aydın, Abdulkadir; Öneş, Kadriye

    2015-01-01

    Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients’ family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

  9. Rehabilitation of spinal cord injuries.

    PubMed

    Nas, Kemal; Yazmalar, Levent; ?ah, Volkan; Ayd?n, Abdulkadir; ne?, Kadriye

    2015-01-18

    Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary. PMID:25621206

  10. Hypertension and a missing kidney

    PubMed Central

    Raina, Rupesh; Gulani, Vikas; Mehta, Lina; Jacobs, Gretta H.; Joyce, Kelly; Ponsky, Todd A.; Kenagy, David N.

    2012-01-01

    Standard initial assessment via ultrasound of a 4-year-old girl with hypertension revealed the absence of one kidney. Instead of cross-sectional imaging of the retroperitoneal space, a functional (nuclear) study was performed. This revealed a malformed kidney within the chest. Though systemic levels of renin and aldosterone were not elevated, removal of the malformed kidney normalized the blood pressure. The presence of prominent smooth muscle nodules surrounding the arteries was seen in the malformed kidney. Initial attempts to avert surgery by pharmacologically reducing blood flow to the malformed kidney were unsuccessful. The review of the literature offers little evidence to support such a strategy. PMID:25874090

  11. Maternal influences on cord blood lead levels.

    PubMed

    Rothenberg, S J; Karchmer, S; Schnaas, L; Perroni, E; Zea, F; Salinas, V; Fernndez Alba, J

    1996-01-01

    We constructed models of umbilical cord blood lead (PbB), with and without the addition of maternal PbB at delivery and earlier in pregnancy, to determine which factors explaining cord PbB depended upon maternal PbB and which did not. We prospectively studied women of low-to-middle socioeconomic status who lived in the Valley of Mexico from 12 weeks of pregnancy to delivery. We measured maternal venous PbB during pregnancy and at delivery, and umbilical cord PbB (1-38 micrograms/dl, 0.05-1.83 mumol/l). We used multiple regression analyses to model cord PbB and a logit analysis to model the maternal-cord PbB relationship. Older mothers using lead-glazed pottery and canned foods delivered babies with increased cord PbB, while those with occasional alcohol use during pregnancy, high milk intake, and more spontaneous abortions delivered babies with lower cord PbB. Maternal PbB at 36 weeks of pregnancy and at delivery independently explained additional variance in cord PbB, but maternal PbB earlier in pregnancy did not. Some of the effects of lead-glazed pottery, maternal abortions, alcohol use, and canned food use on cord PbB were mediated through maternal PbB. The effects of maternal age and milk intake on cord PbB were independent of their influence on maternal PbB near delivery. Cord PbBs were higher than maternal PbBs at delivery in 33% of the cases, and were predominant in mothers over 30 and those drinking milk less than once per day. Measurable influence of maternal PbB on delivery cord PbB is limited to the four to eight weeks prior to delivery. Many factors suspected of influencing bone lead also control cord PbB, some of them independently of their effect on maternal delivery PbB. Minimizing fetal exposure near the end of pregnancy may require long-term control of maternal lead exposure and good management of pregnancy and diet. PMID:8792298

  12. Hepatitis C and Kidney Transplantation

    PubMed Central

    Carbone, Marco; Cockwell, Paul; Neuberger, James

    2011-01-01

    Hepatitis C virus (HCV) infection is relatively common among patients with end-stage kidney disease (ESKD) on dialysis and kidney transplant recipients. HCV infection in hemodialysis patients is associated with an increased mortality due to liver cirrhosis and hepatocellular carcinoma. The severity of hepatitis C-related liver disease in kidney transplant candidates may predict patient and graft survival after transplant. Liver biopsy remains the gold standard in the assessment of liver fibrosis in this setting. Kidney transplantation, not haemodialysis, seems to be the best treatment for HCV+ve patients with ESKD. Transplantation of kidneys from HCV+ve donors restricted to HCV+ve recipients is safe and associated with a reduction in the waiting time. Simultaneous kidney/liver transplantation (SKL) should be considered for kidney transplant candidates with HCV-related decompensated cirrhosis. Treatment of HCV is more complex in hemodialysis patients, whereas treatment of HCV recurrence in SLK recipients appears effective and safe. PMID:21755059

  13. The Kidney Research Predicament

    PubMed Central

    Bryan, Lisa; Ibrahim, Tod; Fischer, Michael J.

    2014-01-01

    Research funding from public and private sources has reached an all-time low. Economic conditions, sequestration, and a trend of low award success rates have created an imbalance between the supply of highly qualified research investigators and the availability of critically necessary research dollars. This grim environment continues to hinder the success of established investigators and deter potential investigators from joining the research workforce. Without action and support of innovative science, the future of the US health care system is in jeopardy, and its leadership role in medical research will decrease. This work discusses the effects of the decline in research funding, the plight of kidney research, and the impact of the American Society of Nephrology Grants Program on scientists. The ASN also calls on the entire nephrology community to rejuvenate the research environment, improve the lives of millions of people with kidney disease, and ultimately, find a cure. PMID:24652790

  14. Cord Formation in a Clinical Isolate of Mycobacterium marinum?

    PubMed Central

    Staropoli, John F.; Branda, John A.

    2008-01-01

    Cord formation is a characteristic property of the cultured Mycobacterium tuberculosis complex species. We describe a case of Mycobacterium marinum demonstrating robust cord formation. Nontuberculous mycobacteria can form true cords in broth culture but do so rarely, despite the fact that many species contain the cell wall glycolipid that mediates cord formation. PMID:18579723

  15. Diabetes after Kidney Donation

    PubMed Central

    Ibrahim, H. N.; Kukla, A.; Cordner, G.; Bailey, R.; Gillingham, K.; Matas, A. J.

    2013-01-01

    Kidney donors, similar to the general population, are at risk for development of type 2 diabetes mellitus (T2DM). The course of donors who develop T2DM has not been studied. We surveyed 3777 kidney donors regarding the development of T2DM. Of the 2954 who responded, 154 developed T2DM 17.7 9.0 years after donation. The multivariable risk of development of T2DM was associated with type 1 DM in the recipient, male gender and body mass index >30 kg/m2 at time of donation. Compared to age, gender, duration after donation and body mass index (BMI)-matched non-diabetic donor controls; diabetic donors were more likely to have hypertension (70.8% vs. 36.2%, p = 0.005), proteinuria (18.8% vs. 3.9%, p < 0.0001) but had a similar serum creatinine. eGFR change after T2DM development was ?0.80 0.94 mL/min/year, ?0.70 0.86 in nondiabetic donors with similar duration after donation and ?0.61 0.76 mL/min/year in age, gender, BMI and duration after donation matched nondiabetic donor controls. These preliminary and shor-term data demonstrate that factors associated with T2DM in kidney donors are similar to those in the general population and donors screened carefully at the time of donation do not appear to have an acceleration of diabetic kidney disease. PMID:20041863

  16. Kidney Cell Electrophoresis

    NASA Technical Reports Server (NTRS)

    Todd, P.

    1985-01-01

    Materials and procedures for microgravity electrophoresis of living human embryonic kidney cells were evaluated, ground support in the form of analytical cell electrophoresis and flow cytometry was provided and cells returned from space flight were analyzed. Preflight culture media, electrophoresis buffer, fraction collection media, temperature profiles, and urokinase assay procedures were tested prior to flight. Electrophoretic mobility distributions of aliquots of the cell population to be fractionated in flight were obtained. The protocol established and utilized is given.

  17. Neonatal Acute Kidney Injury.

    PubMed

    Selewski, David T; Charlton, Jennifer R; Jetton, Jennifer G; Guillet, Ronnie; Mhanna, Maroun J; Askenazi, David J; Kent, Alison L

    2015-08-01

    In recent years, there have been significant advancements in our understanding of acute kidney injury (AKI) and its impact on outcomes across medicine. Research based on single-center cohorts suggests that neonatal AKI is very common and associated with poor outcomes. In this state-of-the-art review on neonatal AKI, we highlight the unique aspects of neonatal renal physiology, definition, risk factors, epidemiology, outcomes, evaluation, and management of AKI in neonates. The changes in renal function with gestational and chronologic age are described. We put forth and describe the neonatal modified Kidney Diseases: Improving Global Outcomes AKI criteria and provide the rationale for its use as the standardized definition of neonatal AKI. We discuss risk factors for neonatal AKI and suggest which patient populations may warrant closer surveillance, including neonates <1500 g, infants who experience perinatal asphyxia, near term/ term infants with low Apgar scores, those treated with extracorporeal membrane oxygenation, and those requiring cardiac surgery. We provide recommendations for the evaluation and treatment of these patients, including medications and renal replacement therapies. We discuss the need for long-term follow-up of neonates with AKI to identify those children who will go on to develop chronic kidney disease. This review highlights the deficits in our understanding of neonatal AKI that require further investigation. In an effort to begin to address these needs, the Neonatal Kidney Collaborative was formed in 2014 with the goal of better understanding neonatal AKI, beginning to answer critical questions, and improving outcomes in these vulnerable populations. PMID:26169430

  18. Rethinking placental transfusion and cord clamping issues.

    PubMed

    Mercer, Judith S; Erickson-Owens, Debra A

    2012-01-01

    A brief delay in clamping the umbilical cord results in a placental transfusion that supplies the infant with a major source of iron during the first few months of life. Cord circulation continues for several minutes after birth and placental transfusion results in approximately 30% more blood volume. Gravity influences the amount of placental transfusion that an infant receives. Placing the infant skin-to-skin requires a longer delay of cord clamping (DCC) than current recommendations. Uterotonics are not contraindicated with DCC. Cord milking is a safe alternative to DCC when one must cut the cord prematurely. Recent randomized controlled trials demonstrate benefits for term and preterm infants from DCC. The belief that DCC causes hyperbilirubinemia or symptomatic polycythemia is unsupported by the available research. Delay of cord clamping substantively increases iron stores in early infancy. Inadequate iron stores in infancy may have an irreversible impact on the developing brain despite oral iron supplementation. Iron deficiency in infancy can lead to neurologic issues in older children including poor school performance, decreased cognitive abilities, and behavioral problems. The management of the umbilical cord in complex situations is inconsistent between birth settings. A change in practice requires collaboration between all types of providers who attend births. PMID:22843002

  19. Claudins and the kidney.

    PubMed

    Yu, Alan S L

    2015-01-01

    Claudins are tight-junction membrane proteins that function as both pores and barriers in the paracellular pathway in epithelial cells. In the kidney, claudins determine the permeability and selectivity of different nephron segments along the renal tubule. In the proximal tubule, claudins have a role in the bulk reabsorption of salt and water. In the thick ascending limb, claudins are important for the reabsorption of calcium and magnesium and are tightly regulated by the calcium-sensing receptor. In the distal nephron, claudins need to form cation barriers and chloride pores to facilitate electrogenic sodium reabsorption and potassium and acid secretion. Aldosterone and the with-no-lysine (WNK) proteins likely regulate claudins to fine-tune distal nephron salt transport. Genetic mutations in claudin-16 and -19 cause familial hypomagnesemic hypercalciuria with nephrocalcinosis, whereas polymorphisms in claudin-14 are associated with kidney stone risk. It is likely that additional roles for claudins in the pathogenesis of other types of kidney diseases have yet to be uncovered. PMID:24948743

  20. Acute kidney injury

    PubMed Central

    Müller, Gerhard Anton

    2015-01-01

    Abstract: Acute kidney injury is a frequent and serious complication in hospitalized patients. Mortality rates have not substantially been decreased during the last 20 years. In most patients AKI results from transient renal hypoperfusion or ischemia. The consequences include tubular cell dysfunction/damage, inflammation of the organ, and post-ischemic microvasculopathy. The two latter events perpetuate kidney damage in AKI. Clinical manifestations result from diminished excretion of water, electrolytes, and endogenous / exogenous waste products. Patients are endangered by cardiovascular complications such as hypertension, heart failure, and arrhythmia. In addition, the whole organism may be affected by systemic toxification (uremia). The diagnostic approach in AKI involves several steps with renal biopsy inevitable in some patients. The current therapy focuses on preventing further kidney damage and on treatment of complications. Different pharmacological strategies have failed to significantly improve prognosis in AKI. If dialysis treatment becomes mandatory, intermittent and continuous renal replacement therapies are equally effective. Thus, new therapies are urgently needed in order to reduce short- and long-term outcome in AKI. In this respect, stem cell-based regimens may offer promising perspectives. PMID:25618438

  1. Claudins and the Kidney

    PubMed Central

    2015-01-01

    Claudins are tight-junction membrane proteins that function as both pores and barriers in the paracellular pathway in epithelial cells. In the kidney, claudins determine the permeability and selectivity of different nephron segments along the renal tubule. In the proximal tubule, claudins have a role in the bulk reabsorption of salt and water. In the thick ascending limb, claudins are important for the reabsorption of calcium and magnesium and are tightly regulated by the calcium-sensing receptor. In the distal nephron, claudins need to form cation barriers and chloride pores to facilitate electrogenic sodium reabsorption and potassium and acid secretion. Aldosterone and the with-no-lysine (WNK) proteins likely regulate claudins to fine-tune distal nephron salt transport. Genetic mutations in claudin-16 and -19 cause familial hypomagnesemic hypercalciuria with nephrocalcinosis, whereas polymorphisms in claudin-14 are associated with kidney stone risk. It is likely that additional roles for claudins in the pathogenesis of other types of kidney diseases have yet to be uncovered. PMID:24948743

  2. Stem cell therapy for the spinal cord

    PubMed Central

    2012-01-01

    Injury and disease of the spinal cord are generally met with a poor prognosis. This poor prognosis is due not only to the characteristics of the diseases but also to our poor ability to deliver therapeutics to the spinal cord. The spinal cord is extremely sensitive to direct manipulation, and delivery of therapeutics has proven a challenge for both scientists and physicians. Recent advances in stem cell technologies have opened up a new avenue for the treatment of spinal cord disease and injury. Stem cells have proven beneficial in rodent models of spinal cord disease and injury. In these animal models, stem cells have been shown to produce their effect by the dual action of cell replacement and the trophic support of the factors secreted by these cells. In this review we look at the main clinical trials involving stem cell transplant into the spinal cord, focusing on motor neuron diseases and spinal cord injury. We will also discuss the major hurdles in optimizing stem cell delivery methods into the spinal cord. We shall examine current techniques such as functional magnetic resonance imaging guidance and cell labeling and will look at the current research striving to improve these techniques. With all caveats and future research taken into account, this is a very exciting time for stem cell transplant into the spinal cord. We are only beginning to realize the huge potential of stem cells in a central nervous system setting to provide cell replacement and trophic support. Many more trials will need to be undertaken before we can fully exploit the attributes of stem cells. PMID:22776143

  3. Spinal cord injury in youth.

    PubMed

    Apple, D F; Anson, C A; Hunter, J D; Bell, R B

    1995-02-01

    To identify special characteristics of the pediatric spinal cord-injured (SCI) population, we analyzed a database of 1,770 traumatic SCI patients; 88 (5%) fell into the two pediatric subgroups: 0-12 years (n = 26) and 13-15 years (n = 62) at time of injury. Differences between age groups were identified with regard to demographics, neurologic characteristics, associated injuries and complications, and management. Mode level of bony injury was C2 in preteens, C4 in teens, and C4-C5 in adults. Scoliosis developed far more frequently in children, particularly preteens (23%), than in adults (5%). Violent etiologies, predominantly gunshots, accounted for a disproportionate share of injuries to preteens (19%) and African-Americans (28%), as compared with adults (12%) and Caucasians (7%). This last finding underscores the urgent need to mount a response to the nationwide proliferation of gunshot-related SCI in children and minorities. PMID:7729113

  4. Fitness and Spinal Cord Injuries

    PubMed Central

    Mackie, J. William; McCormack, Rebecca; Campbell, Duncan

    1989-01-01

    Activity for many disabled persons often begins as therapy, but the additional rewards derived from exercise must be appreciated. Public attitudes toward disabled persons have changed during the last few decades, recently focusing on abilities rather than on disabilities. The family physician of patients with spinal cord injuries will assist in managing acute medical problems and the association with loss of some degree of physical capacity. Physicians also can guide these individuals to choose a life that remains active and interesting over a “house-bound,” but safe, existence. Sensitivity and timing play key roles in establishing exercise as an intergral part of a disabled individuals' altered lifestyle. The physician can advocate increased access to wheelchairs and other facilities that make life easier for disabled individuals. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:21248871

  5. Malignancies of the spinal cord.

    PubMed

    Waters, J Dawn; Peran, Encarnacion Maria Navarro; Ciacci, Joseph

    2012-01-01

    The management of intramedullary spinal cord tumors (IMSCT) is primarily concerned with the preservation of existing neurologic function. To this end, clinical scientists are continually seeking tools and techniques to improve the safety and efficacy of tumor resection and control. Further advances in safety and efficacy can be proposed at each phase of management, from pre-operative screening to post-treatment monitoring. Innovations within the areas of molecular biology and genetics, intraoperative imaging and stereotactic radiosurgery offer exciting new options to explore in the management of IMSCT. This section will review the pathophysiology and epidemiology of IMSCT and the state-of-the-art management before delving into the promising new tools and techniques for each phase of management. PMID:23281516

  6. Nanomedicine for treating spinal cord injury

    NASA Astrophysics Data System (ADS)

    Tyler, Jacqueline Y.; Xu, Xiao-Ming; Cheng, Ji-Xin

    2013-09-01

    Spinal cord injury results in significant mortality and morbidity, lifestyle changes, and difficult rehabilitation. Treatment of spinal cord injury is challenging because the spinal cord is both complex to treat acutely and difficult to regenerate. Nanomaterials can be used to provide effective treatments; their unique properties can facilitate drug delivery to the injury site, enact as neuroprotective agents, or provide platforms to stimulate regrowth of damaged tissues. We review recent uses of nanomaterials including nanowires, micelles, nanoparticles, liposomes, and carbon-based nanomaterials for neuroprotection in the acute phase. We also review the design and neural regenerative application of electrospun scaffolds, conduits, and self-assembling peptide scaffolds.

  7. Sonographic Assessment of the Umbilical Cord

    PubMed Central

    Bosselmann, S.; Mielke, G.

    2015-01-01

    The umbilical cord (UC) is a vital connection between fetus and placenta. It constitutes a stable connection to the fetomaternal interface, while allowing the fetal mobility that is of great importance for fetal development in general and fetal neuromotor development in particular. This combination of mechanical stability and flexibility is due to the architecture of the UC. There is however a range of umbilical cord complications that may be life threatening to the fetus and these too can be explained to a large extent by the cordʼs structural characteristics. This review article discusses clinically relevant aspects of UC ultrasound. PMID:26366000

  8. CHRONIC PAIN FOLLOWING SPINAL CORD INJURY

    PubMed Central

    Masri, Radi; Keller, Asaf

    2013-01-01

    Most patients with insults to the spinal cord or central nervous system suffer from excruciating, unrelenting, chronic pain that is largely resistant to treatment. This condition affects a large percentage of spinal cord injury patients, and numerous patients with multiple sclerosis, stroke and other conditions. Despite the recent advances in basic science and clinical research the pathophysiological mechanisms of pain following spinal cord injury remain unknown. Here we describe a novel mechanism of loss of inhibition within the thalamus that may predispose for the development of this chronic pain and discuss a potential treatment that may restore inhibition and ameliorate pain. PMID:23281514

  9. Thiamine deficiency following umbilical cord blood transplant.

    PubMed

    Trueg, Anne; Borho, Teri; Srivastava, Shivani; Kiel, Patrick

    2013-04-01

    A case of Wernicke encephalopathy (WE) in the setting of umbilical cord blood transplant is reported. The patient, originally diagnosed with Philadelphia chromosome-positive acute lymphoblastic leukemia, proceeded to an umbilical cord blood transplant. He presented with altered mental status 149 days following transplant. Prompt magnetic resonance imaging, baseline thiamine level, and immediate intravenous replacement allowed for recovery of most symptoms. Accompanying this case is a review of the known cases of WE in hematopoietic cell transplants and their causative factors. This is the first known adult case of WE independent of parenteral nutrition use in the setting of umbilical cord transplant. PMID:23239794

  10. Percutaneous umbilical cord blood sampling - series (image)

    MedlinePLUS

    ... the spot where the umbilical cord meets the placenta. He then inserts a needle through your abdomen ... retrieving fetal blood: Placing the needle through the placenta or through the amniotic sac. The placenta's position ...

  11. Brain and Spinal Cord Tumors in Adults

    MedlinePLUS

    ... saved articles window. My Saved Articles » My ACS » Brain and Spinal Cord Tumors in Adults Download Printable ... the topics below to get started. What Is Brain/CNS Tumors In Adults? What are adult brain ...

  12. Umbilical cord blood banking in The Netherlands.

    PubMed

    Jacobs, H C; Falkenburg, J H

    1998-07-01

    Cord blood banks are being developed in the United States and Europe. In The Netherlands, the EuroCord Nederland Foundation (ECN) has been established to coordinate the development of a national cord blood bank for unrelated transplants. The aim of ECN is to collect at least 5000 transplants for patients who lack an HLA-identical related or unrelated bone marrow donor. Four blood banks in Leiden, Groningen, Nijmegen and Amsterdam, Europdonor Foundation and the Department of Hematology of the Leiden University Medical Center participate in this organization. From March 1995 to November 1997, 720 units have been collected, processed, HLA typed, tested for transmissible diseases and cryopreserved in the Dutch cord blood bank. PMID:9715870

  13. Spermatic cord liposarcoma: organ-sparing surgery

    PubMed Central

    Peralta, J P; Godinho, R; Rabaa, C; Reis, M

    2013-01-01

    The authors report a case of a 53-year-old male patient who came to the urologic clinic with symptoms of a left-sided testicular mass with 4?years of evolution. A left inguinal approach was decided for scrotal exploration. High clamping of the spermatic cord was performed with complete excision of the lesion, which was sent for pathology, preserving the spermatic cord and the testicle. The peroperative result was a well-differentiated liposarcoma of the spermatic cord. We then chose to preserve the ipsilateral testis (organ-sparing surgery). Postoperatively, the final pathology confirmed a well-differentiated spermatic cord liposarcoma, revealing negative surgical margins and no signs of local invasion, namely of the underlying structures. The patient is currently doing well, with no signs of recurrence after one and a half year of follow-up. PMID:23814206

  14. Spinal Cord Injury: Hope through Research

    MedlinePLUS

    ... chronic pain in people with spinal cord injury. Robotic-assisted therapy Most recovery following SCI takes place ... the safety and efficacy of a type of robotic therapy device known as the AMES device. The ...

  15. The tethered spinal cord: an overview.

    PubMed

    Patterson, P

    1989-12-01

    The growing child with a tethered spinal cord experiences serious neurological deficits as a result of traction on the conus medullaris. Children with tethered cords most commonly present with pain in the lower back, with motor or sensory loss in the lower limbs, with bowel or bladder dysfunction, or with scoliosis. Often, the neurological basis of these symptoms is overlooked. Surgical release of tethering arrests neurological deterioration. Without surgical intervention symptoms will progressively worsen and may become irreversible. Preoperatively the nurse must prepare the child and his family for neurological investigations and for surgery. Postoperatively the nurse must be skilled in assessing spinal cord function, providing pain management, and assisting in ambulation. This presentation will review the pathophysiology of the tethered spinal cord, the preparation of the school-aged child for surgery, and the postoperative nursing care of the pediatric laminectomy patient. PMID:2688738

  16. Vocal Cord Nodules, Polyps, and Cysts

    MedlinePLUS

    ... affect the degree of disruption of vocal cord vibration and subsequently the severity of hoarseness or other ... source allows the examiner to assess vocal fold vibration. Sometimes a second exam will follow a trial ...

  17. Staging Childhood Brain and Spinal Cord Tumors

    MedlinePLUS

    ... before the cancer is diagnosed and continue for months or years. Childhood brain and spinal cord tumors ... after treatment. Some cancer treatments cause side effects months or years after treatment has ended. These are ...

  18. Tuberculosis of the Spermatic Cord: Case Report☆

    PubMed Central

    Benjelloun, Amine; Elktaibi, Abderrahim; Elharrech, Younes; Touiti, Driss; Ghoundale, Omar

    2014-01-01

    The spermatic cord tuberculoma is uncommon, especially in its lower portion. Most cases were described in Japanese literature. We report a case of tuberculosis of the spermatic cord in a sexually active young man, revealed by a scrotal mass mimicking a tumor of the testicle and discuss the suitable diagnostic and therapeutic procedures, with preservation of the testes and the other sexual organs. PMID:26958480

  19. Imaging diagnosis--split cord malformation.

    PubMed

    Zani, Davide D; De Zani, Donatella; Morandi, Nicola; Biggi, Marianna; Belloli, Angelo G; Riccaboni, Pietro; Rondena, Marco; Di Giancamillo, Mauro; Pravettoni, Davide

    2010-01-01

    The features of a calf with a split cord malformation are described. Clinically, there was severe cervicothoracic kyphoscoliosis and an interscapular dermal sinus associated with cerebrospinal fluid drainage. Using magnetic resonance imaging, complete duplication of the spinal cord at the cervical intumescence was detected. There was associated syringohydromyelia, multiple cervicothoracic vertebral malformations resulting in kyphoscoliosis and rachischisis, herniation of the cerebellar vermis, meningoencephalocele, and calvarial defects. PMID:20166395

  20. CD74 in Kidney Disease

    PubMed Central

    Valio-Rivas, Lara; Baeza-Bermejillo, Ciro; Gonzalez-Lafuente, Laura; Sanz, Ana Belen; Ortiz, Alberto; Sanchez-Nio, Maria Dolores

    2015-01-01

    CD74 (invariant MHC class II) regulates protein trafficking and is a receptor for macrophage migration inhibitory factor (MIF) and d-dopachrome tautomerase (d-DT/MIF-2). CD74 expression is increased in tubular cells and/or glomerular podocytes and parietal cells in human metabolic nephropathies, polycystic kidney disease, graft rejection and kidney cancer and in experimental diabetic nephropathy and glomerulonephritis. Stressors like abnormal metabolite (glucose, lyso-Gb3) levels and inflammatory cytokines increase kidney cell CD74. MIF activates CD74 to increase inflammatory cytokines in podocytes and tubular cells and proliferation in glomerular parietal epithelial cells and cyst cells. MIF overexpression promotes while MIF targeting protects from experimental glomerular injury and kidney cysts, and interference with MIF/CD74 signaling or CD74 deficiency protected from crescentic glomerulonephritis. However, CD74 may protect from interstitial kidney fibrosis. Furthermore, CD74 expression by stressed kidney cells raises questions about the kidney safety of cancer therapy strategies delivering lethal immunoconjugates to CD74-expressing cells. Thus, understanding CD74 biology in kidney cells is relevant for kidney therapeutics. PMID:26441987

  1. [Kidney toxicity's "HAART" therapy].

    PubMed

    Marino, Alfonsina; Ardu, Francesco; Dentone, Chiara; Secondo, Giovanni; Ferrea, G

    2015-01-01

    Human immunodeficiency virus (HIV) and antiretroviral therapy can damage the kidney. Highly active antiretroviral therapy (HAART) generally improves the renal function as it reduces the viral replication, although the renal function may be reduced by certain antiretroviral drugs. HAART causes acute tubular necrosis, acute interstitial nephritis, calculi, Fanconi Syndrome, crystal nephropathy, elevated lipid levels as well as calcium and phosphorus alteration. The physician must estimate renal function before and during antiretroviral therapy, especially when HIV-infected patients have some risk factors for renal damage such as high-blood pressure or hepatitis B or C infections. PMID:26480259

  2. [Infertility and kidney transplantation].

    PubMed

    Atallah, David; Salameh, Charbel; El Kassis, Nadine; Safi, Joelle; Lutfallah, Fouad; Bejjani, Lina; Ghaname, Wadih; Moukarzel, Maroun

    2015-01-01

    Renal failure impairs the endocrine system, especially in women, due to hyperprolactinemia, altering fertility, ovulatory cycles, libido and growth in adolescents. Renal transplantation is considered the best solution to the problems of renal failure and and of dialysis, as evidenced by comparing the rate of hyperprolactinemia (100% in chronic renal failure, 60% in patients on dialysis and 35% in post-transplantation). Kidney transplant is less efficient for restoring perfect function of the hypothalamic-pituitary-gonadal axis due in part to the immunosuppressant regimens prescribed. When these drugs are properly managed, transplantation will restore near normal sexual function. PMID:26591193

  3. Ventral nerve cord in Phoronopsis harmeri larvae.

    PubMed

    Temereva, Elena N

    2012-01-15

    The nervous system organization is considered a phylogenetically important character among metazoans. The phylum Phoronida is included in a supraphyletic taxon known as Lophotrochozoa. Many lophotrochozoans possess a metameric ventral nerve cord as adults or larvae. Phoronids do not exhibit external metamery either as larvae or as adults. The current study describes the ventral nerve cord in the young larva of Phoronopsis harmeri. This structure is apparent both in the serotonergic and FMRF-amidergic nervous system in young larvae. The ventral nerve cord extends from the mouth to the tentacular ridge. Both serotonergic and FMRF-amidergic components consist of two ventrolateral nerves, each with several unipolar neurons. The ventrolateral nerves connect to each other by means of thin repetitive transversal nerves ("commissures"). The abundance of neurons and nerves in the epidermis of the oral field of actinotrocha larva likely reflects the importance of this area in collection of food particles. The ventral nerve cords of the actinotrocha and the metatrochophore differ in their positions with respect to ciliated bands: the cord is located between the preoral and postoral ciliated bands in the actinotrocha but between the postoral ciliated band and telotroch in the metatrochophore. The presence of the ventral nerve cord, which contains repetitive elements (neurons and "commissures"), in the early development of P. harmeri may recapitulate some stages of nervous system development during phoronid phylogeny. The larval nervous system does not contain nervous centers under the tentacular ridge that can correlate with the catastrophic metamorphosis and unique body plan of phoronids. PMID:21898789

  4. Matrix metalloproteinases contribute to kidney fibrosis in chronic kidney diseases

    PubMed Central

    Zhao, Hong; Dong, Yanting; Tian, Xinrui; Tan, Thian Kui; Liu, Zhuola; Zhao, Ye; Zhang, Yun; Harris, David CH; Zheng, Guoping

    2013-01-01

    Matrix metalloproteinases (MMPs) are members of the neutral proteinase family. They were previously thought to be anti-fibrotic because of their ability to degrade and remodel of extracellular matrix. However, recent studies have shown that MMPs are implicated in initiation and progression of kidney fibrosis through tubular cell epithelialmesenchymal transition (EMT) as well as activation of resident fibroblasts, endothelial-mesenchymal transition (EndoMT) and pericyte-myofibroblast transdifferentiation. Interstitial macrophage infiltration has also been shown to correlate with the severity of kidney fibrosis in various chronic kidney diseases. MMPs secreted by macrophages, especially MMP-9, has been shown by us to be profibrotic by induction of tubular cells EMT. EMT is mainly induced by transforming growth factor-? (TGF-?). However, MMP-9 was found by us and others to be up-regulated by TGF-?1 in kidney tubular epithelial cells and secreted by activated macrophages, resulting in EMT and ultimately kidney fibrosis. Therefore, MMP-9 may serve as a potential therapeutic target to prevent kidney fibrosis in chronic kidney disease. This review, by a particular focus on EMT, seeks to provide a comprehensive understanding of MMPs, especially MMP-9, in kidney fibrosis. PMID:24255890

  5. Physiology of kidney renin.

    PubMed

    Castrop, Hayo; Hcherl, Klaus; Kurtz, Armin; Schweda, Frank; Todorov, Vladimir; Wagner, Charlotte

    2010-04-01

    The protease renin is the key enzyme of the renin-angiotensin-aldosterone cascade, which is relevant under both physiological and pathophysiological settings. The kidney is the only organ capable of releasing enzymatically active renin. Although the characteristic juxtaglomerular position is the best known site of renin generation, renin-producing cells in the kidney can vary in number and localization. (Pro)renin gene transcription in these cells is controlled by a number of transcription factors, among which CREB is the best characterized. Pro-renin is stored in vesicles, activated to renin, and then released upon demand. The release of renin is under the control of the cAMP (stimulatory) and Ca(2+) (inhibitory) signaling pathways. Meanwhile, a great number of intrarenally generated or systemically acting factors have been identified that control the renin secretion directly at the level of renin-producing cells, by activating either of the signaling pathways mentioned above. The broad spectrum of biological actions of (pro)renin is mediated by receptors for (pro)renin, angiotensin II and angiotensin-(1-7). PMID:20393195

  6. Klotho and kidney disease

    PubMed Central

    Hu, Ming-Chang; Kuro-o, Makoto; Moe, Orson W.

    2011-01-01

    Klotho is a single-pass transmembrane protein that exerts its biological functions through multiple modes. Membrane-bound Klotho acts as coreceptor for the major phosphatonin fibroblast growth factor-23 (FGF23), while soluble Klotho functions as an endocrine substance. In addition to in the distal nephron where it is abundantly expressed, Klotho is present in the proximal tubule lumen where it inhibits renal Pi excretion by modulating Na-coupled Pi transporters via enzymatic glycan modification of the transporter proteins an effect completely independent of its role as the FGF23 coreceptor. Acute kidney injury (AKI) and chronic kidney disease (CKD) are states of systemic Klotho deficiency, making Klotho a very sensitive biomarker of impaired renal function. In addition to its role as a marker, Klotho also plays pathogenic roles in renal disease. Klotho deficiency exacerbates decreases in, while Klotho repletion or excess preserves, glomerular filtration rate in both AKI and CKD. Soft tissue calcification, and especially vascular calcification, is a dire complication in CKD, associated with high mortality. Klotho protects against soft tissue calcification via at least 3 mechanisms: phosphaturia, preservation of renal function and a direct effect on vascular smooth muscle cells by inhibiting phosphate uptake and dedifferentiation. In summary, Klotho is a critical molecule in a wide variety of renal diseases and bears great potential as a diagnostic and prognostic biomarker as well as for therapeutic replacement therapy. PMID:21170871

  7. Pruritus in Kidney Disease.

    PubMed

    Combs, Sara A; Teixeira, J Pedro; Germain, Michael J

    2015-07-01

    Pruritus is a common and distressing symptom in patients with chronic kidney disease. The most recent epidemiologic data have suggested that approximately 40% of patients with end-stage renal disease experience moderate to severe pruritus and that uremic pruritus (UP) has a major clinical impact, being associated strongly with poor quality of life, impaired sleep, depression, and increased mortality. The pathogenesis of UP remains largely unclear, although several theories on etiologic or contributing factors have been proposed including increased systemic inflammation; abnormal serum parathyroid hormone, calcium, and phosphorus levels; an imbalance in opiate receptors; and a neuropathic process. UP can present somewhat variably, although it tends to affect large, discontinuous, but symmetric, areas of skin and to be most symptomatic at night. A variety of alternative systemic or dermatologic conditions should be considered, especially in patients with asymmetric pruritus or other atypical features. Treatment initially should focus on aggressive skin hydration, patient education on minimizing scratching, and optimization of the aspects of chronic kidney disease care that are most relevant to pruritus, including dialysis adequacy and serum parathyroid hormone, calcium, and phosphorus management. Data for therapy specifically for UP remain limited, although topical therapies, gabapentin, type B ultraviolet light phototherapy, acupuncture, and opioid-receptor modulators all may play a role. PMID:26355256

  8. Genetic kidney diseases

    PubMed Central

    Hildebrandt, Friedhelm

    2010-01-01

    Knowledge of the primary cause of a disease is essential for understanding its mechanisms and for adequate classification, prognosis, and treatment. Recently, the etiologies of many kidney diseases have been revealed as single-gene defects. This is exemplified by steroid-resistant nephrotic syndrome, which is caused by podocin mutations in ~25% of childhood and ~15% of adult cases. Knowledge of a disease-causing mutation in a single-gene disorder represents one of the most robust diagnostic examples of personalized medicine, because the mutation conveys an almost 100% risk of developing the disease by a certain age. Whereas single-gene diseases are rare disorders, polygenic risk alleles are found in common adult-onset diseases. This review will discuss prominent renal single-gene kidney disorders and polygenic risk alleles of common disorders. We delineate how emerging techniques of total exome capture and large-scale sequencing will facilitate molecular genetic diagnosis, prognosis and specific therapy and lead to a better understanding of disease mechanisms, thus enabling development of new targeted drugs. PMID:20382325

  9. Acute Kidney Injury.

    PubMed

    Zuk, Anna; Bonventre, Joseph V

    2016-01-14

    Acute kidney injury (AKI) is a global public health concern associated with high morbidity, mortality, and healthcare costs. Other than dialysis, no therapeutic interventions reliably improve survival, limit injury, or speed recovery. Despite recognized shortcomings of in vivo animal models, the underlying pathophysiology of AKI and its consequence, chronic kidney disease (CKD), is rich with biological targets. We review recent findings relating to the renal vasculature and cellular stress responses, primarily the intersection of the unfolded protein response, mitochondrial dysfunction, autophagy, and the innate immune response. Maladaptive repair mechanisms that persist following the acute phase promote inflammation and fibrosis in the chronic phase. Here macrophages, growth-arrested tubular epithelial cells, the endothelium, and surrounding pericytes are key players in the progression to chronic disease. Better understanding of these complex interacting pathophysiological mechanisms, their relative importance in humans, and the utility of biomarkers will lead to therapeutic strategies to prevent and treat AKI or impede progression to CKD or end-stage renal disease (ESRD). PMID:26768243

  10. The kidney in space.

    PubMed

    Liakopoulos, Vassilios; Leivaditis, Konstantinos; Eleftheriadis, Theodoros; Dombros, Nicholas

    2012-12-01

    Renal adaptation in space has been studied during various space missions since the early 70s. Technical and financial disadvantages of performing experiments under real microgravity conditions have warranted the conductance of relative studies under simulated weightlessness on earth. Arriving in microgravity leads to a redistribution of body fluids to the upper part of the body and an exaggerated extravasation very early in-flight. Plasma volume as well as skin evaporation and oral hydration are reduced, while total body water seems to remain stable. Urinary sodium is diminished and a substantial amount of sodium is retained outside the intravascular space. Glomerular filtration rate shows a transient mild increase. Urinary albumin excretion is reduced although initial studies had demonstrated the opposite. Examination of renal histopathology after exposure to simulated microgravity in rats revealed glomerular atrophy, interstitial edema, and degeneration of renal tubular cells. Acute urinary retention which has been reported during spaceflights can lead to certain medical complications that could compromise an entire mission. Kidney stone formation is another important potential hazard for any manned spaceflight. Increased kidney stone formation in space is attributed to several factors including reduced fluid intake, hypercalciuria, and the presence of nanobacteria. Nutritional and pharmacological interventions are currently recommended as preventive measures against renal stone formation in space travelers. PMID:23001611

  11. Murine Kidney Transplant Technique.

    PubMed

    Plenter, Robert; Jain, Swati; Ruller, Chelsea M; Nydam, Trevor L; Jani, Alkesh H

    2015-01-01

    The first mouse kidney transplant technique was published in 1973(1) by the Russell laboratory. Although it took some years for other labs to become proficient in and utilize this technique, it is now widely used by many laboratories around the world. A significant refinement to the original technique using the donor aorta to form the arterial anastomosis instead of the renal artery was developed and reported in 1993 by Kalina and Mottram (2) with a further advancement coming from the same laboratory in 1999 (3). While one can become proficient in this model, a search of the literature reveals that many labs still experience a high proportion of graft loss due to arterial thrombosis. We describe here a technique that was devised in our laboratory that vastly reduces the arterial thrombus reported by others (4,5). This is achieved by forming a heel-and-toe cuff of the donor infra-renal aorta that facilitates a larger anastomosis and straighter blood flow into the kidney. PMID:26555373

  12. Obesity and kidney protection

    PubMed Central

    Chandra, Aravind; Biersmith, Michael; Tolouian, Ramin

    2014-01-01

    Context: Obesity, both directly and indirectly, increases the risk for a variety of disease conditions including diabetes, hypertension, liver disease, and certain cancers, which in turn, decreases the overall lifespan in both men and women. Though the cardiovascular risks of obesity are widely acknowledged, less often identified is the relationship between obesity and renal function. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. Results: The concept of the “Metabolic Syndrome“ helps us to understand this close link between obesity, diabetes, hypertension, and renal dysfunction. An elevated body mass index has shown to be one of the major determinants of glomerular hyperfiltration that lead to the development of chronic kidney disease. Interestingly, weight loss can lead to attenuation of hyperfiltration in severely obese patients suggesting a possible therapeutic option to combat obesity-related hyperfiltration. Conclusions: Various treatment strategies had been suggested to decrease impact of obesity on kidneys. These are blood pressure controling, inhibition of the renin-angiotensinaldosterone axis, improving glycemic control, improving dyslipidemia, improving protein uriaand lifestyle modifications. Regardless of the numerous pharmacotherapies, the focus should be on the root cause: obesity. PMID:25093156

  13. Inadvertent Transmission of Polycystic Kidney Disease in Kidney Transplantation

    PubMed Central

    Langote, Amit; Mazarova, Andrea; Mahoney, John; Blew, Brian; Knoll, Greg A.

    2015-01-01

    Patient: Male, 55 Final Diagnosis: Polycystic transformation of transplant kidney Symptoms: Hematuia Medication: Tacrolimus • Mycophenoalte Moefitil • Prednisone Clinical Procedure: Graft nephrectomy Specialty: Nephrology Objective: Unusual clinical course Background: Although organ donors are rigorously tested, occasionally an unidentified donor disease can be transmitted to the recipient. These conditions include malignancies, infections, and, rarely, congenital diseases. Case Report: We report a case of an inadvertent transmission of polycystic kidney disease from a 40-year-old trauma victim to both kidney recipients. There was no family history of renal disease in the donor. The renal allografts gradually increased in size with the development of cysts and functioned for 10 and 14 years. Conclusions: We report a case of inadvertent transmission of polycystic kidney disease from an unsuspecting deceased donor to both the recipients through renal allograft. Both the grafts lasted long enough to suggest that polycystic kidneys from deceased donors can be considered for transplantation. PMID:25716074

  14. Experimental bypass surgery between the spinal cord and caudal nerve roots for spinal cord injuries.

    PubMed

    Dam-Hieu, P; Liu, S; Tadi, M

    2004-11-01

    Spinal cord injuries often cause permanent neurological deficits and are still considered as inaccessible to efficient therapy. Injured spinal cord axons are unable to spontaneously regenerate in adult mammalians. Re-establishing functional activity especially in the lower limbs by reinnervating the caudal infra-lesional territories could represent an attractive therapeutic strategy. For several years, we have studied and developed surgical bypasses using peripheral nerve grafts bridging the supra-lesional rostral spinal cord to the caudal infra-lesional lumbar roots. Main objectives were: 1- to overcome the spinal cord lesion and the consecutive glial barrier blocking the axonal regeneration; 2- to find and bring an alternative source of regenerating axons; 3- to guide those axons toward precisely definite targets (for example, lower limb muscles). We report here the results of our experimental research, which led us from animal experimental models (rodents, primates) to the first human experimentation. Limitations of the method (especially technical pitfalls) are numerous. However, we have obtained encouraging results in our attempts to "repair" the motor pathway. Functional recovery with strong evidence of centrifugal axonal regeneration from the spinal cord to the periphery has been observed. Regarding the sensory pathway, we have found evidence of centripetal axonal regeneration from the periphery toward the spinal cord. Further studies are obviously advocated, but our experimental model of spinal cord - nerve roots bypasses may be integrated in future "repair" strategies of both motor and sensory pathways following spinal cord injury. PMID:15654303

  15. Adiposity and spinal cord injury

    PubMed Central

    Gorgey, Ashraf S; Wells, Kathryn M; Austin, Timothy L

    2015-01-01

    The drastic changes in body composition following spinal cord injury (SCI) have been shown to play a significant role in cardiovascular and metabolic health. The pattern of storage and distribution of different types of adipose tissue may impact metabolic health variables similar to carbohydrate, lipid and bone metabolism. The use of magnetic resonance imaging provides insights on the interplay among different regional adipose tissue compartments and their role in developing chronic diseases. Regional adipose tissue can be either distributed centrally or peripherally into subcutaneous and ectopic sites. The primary ectopic adipose tissue sites are visceral, intramuscular and bone marrow. Dysfunction in the central nervous system following SCI impacts the pattern of distribution of adiposity especially between tetraplegia and paraplegia. The current editorial is focused primarily on introducing different types of adipose tissue and establishing scientific basis to develop appropriate dietary, rehabilitation or pharmaceutical interventions to manage the negative consequences of increasing adiposity after SCI. We have also summarized the clinical implications and future recommendations relevant to study adiposity after SCI. PMID:26396933

  16. Muscle after spinal cord injury.

    PubMed

    Biering-Srensen, Bo; Kristensen, Ida Bruun; Kjaer, Michael; Biering-Srensen, Fin

    2009-10-01

    The morphological and contractile changes of muscles below the level of the lesion after spinal cord injury (SCI) are dramatic. In humans with SCI, a fiber-type transformation away from type I begins 4-7 months post-SCI and reaches a new steady state with predominantly fast glycolytic IIX fibers years after the injury. There is a progressive drop in the proportion of slow myosin heavy chain (MHC) isoform fibers and a rise in the proportion of fibers that coexpress both the fast and slow MHC isoforms. The oxidative enzymatic activity starts to decline after the first few months post-SCI. Muscles from individuals with chronic SCI show less resistance to fatigue, and the speed-related contractile properties change, becoming faster. These findings are also present in animals. Future studies should longitudinally examine changes in muscles from early SCI until steady state is reached in order to determine optimal training protocols for maintaining skeletal muscle after paralysis. PMID:19705475

  17. Kidney Disease: Early Detection and Treatment

    MedlinePLUS

    ... Bar Home Current Issue Past Issues Special Section Kidney Disease: Early Detection and Treatment Past Issues / Winter ... called a "urine albumin-to-creatinine ratio." Treating Kidney Disease Kidney disease is usually a progressive disease, ...

  18. High Blood Pressure and Kidney Disease

    MedlinePLUS

    ... Information Center National Kidney Foundation Smokefree.gov MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Alternate Language URL Español High Blood Pressure and Kidney Disease Page Content On this page: What is ...

  19. Genetics Home Reference: Polycystic kidney disease

    MedlinePLUS

    ... Recent literature OMIM Genetic disorder catalog Conditions > Polycystic kidney disease On this page: Description Genetic changes Inheritance ... Glossary definitions Reviewed May 2014 What is polycystic kidney disease? Polycystic kidney disease is a disorder that ...

  20. Kidney Disease Statistics for the United States

    MedlinePLUS

    ... also order print versions from our online catalog. Kidney Disease Statistics for the United States Page Content ... for Vascular Access Acknowledgments The Growing Burden of Kidney Disease Kidney disease statistics for the United States ...

  1. Treatment Methods for Kidney Failure: Peritoneal Dialysis

    MedlinePLUS

    ... Life Options Rehabilitation Program National Kidney Foundation, Inc. Kidney and Urologic Disease Organizations Many organizations provide support ... 345 KB)​​​​​ Alternate Language URL Treatment Methods for Kidney Failure: Peritoneal Dialysis Page Content On this page: ...

  2. Genetics Home Reference: Polycystic kidney disease

    MedlinePLUS

    ... the urine (hematuria), recurrent urinary tract infections, kidney stones, and heart valve abnormalities. Additionally, people with polycystic ... valve ; hematuria ; hemodialysis ; hypertension ; inheritance ; inherited ; kidney ; kidney stones ; mutation ; new mutation ; nucleus ; pattern of inheritance ; polycystic ...

  3. Split Cord Malformation Combined with Tethered Cord Syndrome in an Adult

    PubMed Central

    Kim, Young Deok; Sung, Ji Hoon; Lee, Sang Won

    2013-01-01

    Split cord malformations (SCMs) usually present in childhood, and are rarely reported in adults. And also, a cervicothoracic SCM associated with tethered cord syndrome has very rarely been reported in the literature. We report a case of SCM associated with tethered cord and spina bifida in an adult. This report describes the case of a 34-year-old woman who presented for evaluation of neck pain, back pain, and intermittent paraparesis of several months duration. The MRI and CT showed a SCM at the cervicothoracic level and a fibrous septum at the thoracic level. She underwent surgery for the SCM and tethered cord syndrome, and was followed for 7 years. Patient presented complete recovery in the follow-up. The authors discuss this unusual lesion and describe the anatomical relationship of the level of cord duplication and fibrous septum. PMID:24294465

  4. Tubulocystic carcinoma of the kidney

    PubMed Central

    Adair, Carol F.; Zhang, Haiying

    2015-01-01

    Tubulocystic carcinoma (TCC) of the kidney is a unique, rare, and recently recognized neoplasm. Although originally considered a low-grade collecting duct carcinoma, TCC is now considered to be a distinct entity. TCC should be considered in the differential diagnosis of cystic renal neoplasms. We report a case of TCC arising in the left kidney. PMID:26130898

  5. Calcium Supplements and Kidney Health

    MedlinePLUS Videos and Cool Tools

    ... Calcium_Supplements_101415.html Calcium Supplements and Kidney Health HealthDay News Video - October 15, 2015 To use ... health news that matters to you. Related MedlinePlus Health Topics Calcium Dietary Supplements Kidney Stones About MedlinePlus ...

  6. Screening for Chronic Kidney Disease

    MedlinePLUS

    ... least 3 months. Normally, the kidneys filter extra water and waste out of the blood and make urine. The ... to estimate how well the kidneys are filtering waste out of the blood. Potential ... lead to early treatment, which might result in better outcomes for people ...

  7. Bochdalek hernia with intrathoracic kidney

    PubMed Central

    Shah, Arti D.; Ajay, Stani; Adalia, Mayur; Rathi, Amar

    2012-01-01

    Bochdalek hernia is a congenital diaphragmatic defect that allows abdominal viscera to herniate into the thorax. Intrathoracic kidney is a very rare finding representing less than 5% of all renal ectopias. A 20 year old female presented with complaints of dry cough since 15 days and intermittent fever of 4 days duration. As part of routine investigation chest X-ray was done which showed a left retro-cardiac homogenous opacity, rest of the lung field appeared normal. Abdominal ultrasound showed the right kidney to be normal, left kidney was not visualized. Computed tomography scan demonstrated left-sided Bochdalek hernia with the left kidney within the thorax. An IVP was done to confirm the diagnosis. Many a times intrathoracic kidney is confused with a thoracic mass and the patient undergoes a battery of unnecessary investigations, surgical interventions and image guided biopsies for the same, hence to avoid this we are reporting this case. PMID:23243354

  8. APOL1 Localization in Normal Kidney and Nondiabetic Kidney Disease

    PubMed Central

    Madhavan, Sethu M.; O'Toole, John F.; Konieczkowski, Martha; Ganesan, Santhi; Bruggeman, Leslie A.

    2011-01-01

    In patients of African ancestry, genetic variants in APOL1, which encodes apolipoprotein L1, associate with the nondiabetic kidney diseases, focal segmental glomerulosclerosis (FSGS), HIV-associated nephropathy (HIVAN), and hypertensive nephropathy. Understanding the renal localization of APOL1 may provide clues that will ultimately help elucidate the mechanisms by which APOL1 variants promote nephropathy. Here, we used immunohistology to examine APOL1 localization in normal human kidney sections and in biopsies demonstrating either FSGS (n = 8) or HIVAN (n = 2). Within normal glomeruli, APOL1 only localized to podocytes. Compared with normal glomeruli, fewer cells stained for APOL1 in FSGS and HIVAN glomeruli, even when expression of the podocyte markers GLEPP1 and synaptopodin appeared normal. APOL1 localized to proximal tubular epithelia in normal kidneys, FSGS, and HIVAN. We detected APOL1 in the arteriolar endothelium of normal and diseased kidney sections. Unexpectedly, in both FSGS and HIVAN but not normal kidneys, the media of medium artery and arterioles contained a subset of ?-smooth muscle actin-positive cells that stained for APOL1. Comparing the renal distribution of APOL1 in nondiabetic kidney disease to normal kidney suggests that a previously unrecognized arteriopathy may contribute to disease pathogenesis in patients of African ancestry. PMID:21997392

  9. Melioidosis and the kidney.

    PubMed

    Jabbar, Zulfikar; Currie, Bart J

    2013-03-01

    Melioidosis, caused by the saprophytic soil and freshwater Gram-negative aerobic bacillus Burkholderia pseudomallei, is classically characterized by pneumonia, sometimes with multiple organ abscesses, usually in patients with defined risk factors and with a mortality rate of up to 40%. It is a major cause of community-acquired sepsis in Southeast Asia and tropical northern Australia with an expanding global geographical distribution. It is increasingly recognized as an opportunistic infectious disease of importance to physicians, who may need to suspect it in at-risk patients that may come from or visit endemic areas, and could be fatal if treated late or inappropriately. Mortality could be prevented by early institution of specific antimicrobial therapy. Epidemiology, clinical features, overall management, and aspects of melioidosis particularly relevant to kidney disease and immunosuppression are discussed in this review. PMID:23279670

  10. Wars, disasters and kidneys.

    PubMed

    Lameire, N

    2014-12-01

    This paper summarizes the impact that wars had on the history of nephrology, both worldwide and in the Ghent Medical Faculty notably on the definition, research and clinical aspects of acute kidney injury. The paper briefly describes the role of 'trench nephritis' as observed both during World War I and II, supporting the hypothesis that many of the clinical cases could have been due to Hantavirus nephropathy. The lessons learned from the experience with crush syndrome first observed in World War II and subsequently investigated over many decades form the basis for the creation of the Renal Disaster Relief Task Force of the International Society of Nephrology. Over the last 15 years, this Task Force has successfully intervened both in the prevention and management of crush syndrome in numerous disaster situations like major earthquakes. PMID:25409904

  11. Metals and kidney autoimmunity.

    PubMed Central

    Bigazzi, P E

    1999-01-01

    The causes of autoimmune responses leading to human kidney pathology remain unknown. However, environmental agents such as microorganisms and/or xenobiotics are good candidates for that role. Metals, either present in the environment or administered for therapeutic reasons, are prototypical xenobiotics that cause decreases or enhancements of immune responses. In particular, exposure to gold and mercury may result in autoimmune responses to various self-antigens as well as autoimmune disease of the kidney and other tissues. Gold compounds, currently used in the treatment of patients with progressive polyarticular rheumatoid arthritis, can cause a nephrotic syndrome. Similarly, an immune-mediated membranous nephropathy frequently occurred when drugs containing mercury were commonly used. Recent epidemiologic studies have shown that occupational exposure to mercury does not usually result in autoimmunity. However, mercury induces antinuclear antibodies, sclerodermalike disease, lichen planus, or membranous nephropathy in some individuals. Laboratory investigations have confirmed that the administration of gold or mercury to experimental animals leads to autoimmune disease quite similar to that observed in human subjects exposed to these metals. In addition, studies of inbred mice and rats have revealed that a few strains are susceptible to the autoimmune effects of gold and mercury, whereas the majority of inbred strains are resistant. These findings have emphasized the importance of genetic (immunogenetic and pharmacogenetic) factors in the induction of metal-associated autoimmunity. (italic)In vitro(/italic) and (italic)in vivo(/italic) research of autoimmune disease caused by mercury and gold has already yielded valuable information and answered a number of important questions. At the same time it has raised new issues about possible immunostimulatory or immunosuppressive mechanisms of xenobiotic activity. Thus it is evident that investigations of metal-induced renal autoimmunity have the potential to produce new knowledge with relevance to autoimmune disease caused by xenobiotics in general as well as to idiopathic autoimmunity. PMID:10502542

  12. Spinal cord ischemia after cardiac arrest.

    PubMed

    Imaizumi, H; Ujike, Y; Asai, Y; Kaneko, M; Chiba, S

    1994-01-01

    Subsequent to cardiac arrest, a 58-year-old man with intractable dysrhythmia and severe arteriosclerosis developed flaccid paraplegia, depressed deep tendon reflexes, and showed no pain or temperature sensation caudal to Th-7 in spite of completely intact proprioception and vibration sensation. An echocardiogram showed no clots or vegetation on the prosthetic valve and no thrombus in the left atrium or left ventricle. The patient's paraplegia was permanent, at least through a follow-up period of 2 years. These findings suggest that the etiology was spinal cord ischemia due to blood supply in the area of the anterior spinal artery (ASA); however, magnetic resonance T2-weighted imaging demonstrated signal abnormalities throughout the gray matter and in the adjacent center white matter. Somatosensory-evoked potentials (SEP) measure neural transmission in the afferent spinal cord pathway, which is located in the lateral and posterior columns of the white matter; these showed a delay in latency between Th-6 and Th-7. The spinal cord is as vulnerable to transient ischemia as the brain. Spinal cord ischemia after cardiac arrest results from principal damage in the anterior horn of the gray matter, the so-called ASA syndrome; however, the pathways of SEP and pathogenesis of the spinal cord ischemia need further investigation. PMID:7884198

  13. Proprioceptive pathways of the spinal cord.

    PubMed Central

    Schneider, R J; Kulics, A T; Ducker, T B

    1977-01-01

    In the Macaque, surgical lesions were made in the dorsal funiculus, in the dorsolateral funiculus, and through half of the spinal cord. The somatosensory and motor capacity of the animal were examined neurologically and electrophysiologically. The exact lesion was then confirmed pathologically in detail. The results of these experiments indicate that limb position information from the distal limb and proximal limb are relayed to the brain in two different fashions. Distal limb position information, especially the cortical representation of the limbs' volar surface as it moves in space, is drastically impaired by dorsal funiculus or posterior white column lesions. Proximal limb position may or may not be impaired by similar lesions, for this information while initially in the dorsal or posterior white columns is sorted out (as it ascends in the spinal cord) to the dorsolateral funiculus or white columns. For example, in the lower thoracic spinal cord, both distal and proximal hind limb sensation are impaired by posterior white column damage; in the cervical cord, only distal sensation is impaired by the same lesion, and proximal information is spared. We refer to this neuroanatomic rearranging as "fibre sorting", and we believe that it is clinically significant in spinal cord disease. Images PMID:408463

  14. Rehabilitation and treatment of spinal cord tumors

    PubMed Central

    Raj, Vishwa S.; Lofton, LaTanya

    2013-01-01

    Context Due to advances in acute oncological treatment, patients with spinal cord tumors exhibit improved survival. However, these patients have not received the full benefits of rehabilitation services to address their neurological deficits and rehabilitation goals. Objective To evaluate the epidemiology and pathophysiology of spinal cord tumors, address methods of acute oncological management, review treatment for neurological sequelae, and understand the implications as they relate to rehabilitation. Methods An extensive literature review was performed regarding the epidemiology, pathophysiology, acute oncological management, neurological sequelae, and rehabilitation for patients with spinal cord tumors. Databases used included pubmed.gov and OVID, as well as individual journal and textbook articles. Results Access to treatment should be increased given improved survival and functional deficits for patients with spinal cord tumors. Individuals can benefit from inpatient rehabilitation programs, in spite of increased medical co-morbidity and neurological deficits. Specific areas of improvement include functionality, mood, quality of life, and survival. Adjustments to treatment plans must incorporate medical complications from cancer and its treatment, perceived quality of life, and prognosis. Conclusions Patients with spinal cord tumors who participate in rehabilitation programs show general improvement in function, mood, quality of life, and survival. Adaptations to care plans should be made to accommodate medical co-morbidities from cancer and its treatment, patient perceptions, and prognosis. PMID:23433329

  15. Human umbilical cord mesenchymal stem cell transplantation restores damaged ovaries

    PubMed Central

    Zhu, Shao-Fang; Hu, Hong-Bo; Xu, Hong-Yan; Fu, Xia-Fei; Peng, Dong-Xian; Su, Wei-Yan; He, Yuan-Li

    2015-01-01

    Ovarian injury because of chemotherapy can decrease the levels of sexual hormones and potentia generandi of patients, thereby greatly reducing quality of life. The goal of this study was to investigate which transplantation method for human umbilical cord mesenchymal stem cells (HUMSCs) can recover ovarian function that has been damaged by chemotherapy. A rat model of ovarian injury was established using an intraperitoneal injection of cyclophosphamide. Membrane-labelled HUMSCs were subsequently injected directly into ovary tissue or tail vein. The distribution of fluorescently labelled HUMSCs, estrous cycle, sexual hormone levels, and potentia generandi of treated and control rats were then examined. HUMSCs injected into the ovary only distributed to the ovary and uterus, while HUMSCs injected via tail vein were detected in the ovary, uterus, kidney, liver and lung. The estrous cycle, levels of sex hormones and potentia generandi of the treated rats were also recovered to a certain degree. Moreover, in some transplanted rats, fertility was restored and their offspring developed normally. While ovary injection could recover ovarian function faster, both methods produced similar results in the later stages of observation. Therefore, our results suggest that transplantation of HUMSCs by tail vein injection represents a minimally invasive and effective treatment method for ovarian injury. PMID:25922900

  16. Human umbilical cord mesenchymal stem cell transplantation restores damaged ovaries.

    PubMed

    Zhu, Shao-Fang; Hu, Hong-Bo; Xu, Hong-Yan; Fu, Xia-Fei; Peng, Dong-Xian; Su, Wei-Yan; He, Yuan-Li

    2015-09-01

    Ovarian injury because of chemotherapy can decrease the levels of sexual hormones and potentia generandi of patients, thereby greatly reducing quality of life. The goal of this study was to investigate which transplantation method for human umbilical cord mesenchymal stem cells (HUMSCs) can recover ovarian function that has been damaged by chemotherapy. A rat model of ovarian injury was established using an intraperitoneal injection of cyclophosphamide. Membrane-labelled HUMSCs were subsequently injected directly into ovary tissue or tail vein. The distribution of fluorescently labelled HUMSCs, estrous cycle, sexual hormone levels, and potentia generandi of treated and control rats were then examined. HUMSCs injected into the ovary only distributed to the ovary and uterus, while HUMSCs injected via tail vein were detected in the ovary, uterus, kidney, liver and lung. The estrous cycle, levels of sex hormones and potentia generandi of the treated rats were also recovered to a certain degree. Moreover, in some transplanted rats, fertility was restored and their offspring developed normally. While ovary injection could recover ovarian function faster, both methods produced similar results in the later stages of observation. Therefore, our results suggest that transplantation of HUMSCs by tail vein injection represents a minimally invasive and effective treatment method for ovarian injury. PMID:25922900

  17. Causes of Spinal Cord Injury

    PubMed Central

    2013-01-01

    Background: Knowledge of the causes of spinal cord injury (SCI) and associated factors is critical in the development of successful prevention programs. Objective: This study analyzed data from the National SCI Database (NSCID) and National Shriners SCI Database (NSSCID) in the United States to examine specific etiologies of SCI by age, sex, race, ethnicity, day and month of injury, and neurologic outcomes. Methods: NSCID and NSSCID participants who had a traumatic SCI from 2005 to 2011 with known etiology were included in the analyses (N=7,834). Thirty-seven causes of injury documented in the databases were stratified by personal characteristics using descriptive analysis. Results: The most common causes of SCI were automobile crashes (31.5%) and falls (25.3%), followed by gunshot wounds (10.4%), motorcycle crashes (6.8%), diving incidents (4.7%), and medical/surgical complications (4.3%), which collectively accounted for 83.1% of total SCIs since 2005. Automobile crashes were the leading cause of SCI until age 45 years, whereas falls were the leading cause after age 45 years. Gunshot wounds, motorcycle crashes, and diving caused more SCIs in males than females. The major difference among race/ethnicity was in the proportion of gunshot wounds. More SCIs occurred during the weekends and warmer months, which seemed to parallel the increase of motorcycle- and diving-related SCIs. Level and completeness of injury are also associated with etiology of injury. Conclusions: The present findings suggest that prevention strategies should be tailored to the targeted population and major causes to have a meaningful impact on reducing the incidence of SCI. PMID:23678280

  18. What Are the Treatments for Spinal Cord Injury (SCI)?

    MedlinePLUS

    ... Resources and Publications What are the treatments for spinal cord injury (SCI)? Skip sharing on social media links Share ... National Institute of Neurological Disorders and Stroke. (2012). Spinal cord injury: Hope through research . Retrieved May 22, 2012, from ...

  19. Survival Rates for Selected Childhood Brain and Spinal Cord Tumors

    MedlinePLUS

    ... and spinal cord tumors in children treated? Survival rates for selected childhood brain and spinal cord tumors ... be lower. Type of Tumor 5-Year Survival Rate Pilocytic astrocytoma About 95% Fibrillary (diffuse) astrocytoma About ...

  20. Angiomyxoma: a rare tumor of the umbilical cord

    PubMed Central

    Göksever, Hale; Celiloğlu, Murat; Küpelioğlu, Ali

    2010-01-01

    Tumors of the umbilical cord are rare anomalies and should be considered when using prenatal ultrasound for detection of cystic lesions. Differential diagnosis of umbilical cord tumors should comprise umbilical cord teratoma, hemangioma and angiomyxoma. It can also be an umbilical cord polyp, umbilical cord cyst, hernia into the cord and omphalocele, which are mostly isolated findings, except omphalocele. Angiomyxoma is a rare tumor of the umbilical cord and is associated with incresaed perinatal morbidity and mortality. We present a 22-year-old woman with a large umbilical cord tumor who underwent a caesarean section. As in our case, neither chromosomal aberrations nor elevated alphafetoprotein were found after amniocentesis or chordocentesis. Macroscopical and microscopical pathological examinations of the mass after delivery revealed an angiomyxoma with cystic degenerations in myxoid stroma. PMID:24591896

  1. Vocational Rehabilitation of Persons with Spinal Cord Injuries

    ERIC Educational Resources Information Center

    Poor, Charles R.

    1975-01-01

    Reviews historical development of organized vocational rehabilitation programming for the spinal cord injured in the United States. Significant factors that affect vocational rehabilitation outcomes with spinal cord injured persons are listed and discussed. (Author)

  2. Committee Opinion No. 648 Summary: Umbilical Cord Blood Banking.

    PubMed

    2015-12-01

    Once considered a waste product that was discarded with the placenta, umbilical cord blood is now known to contain potentially life-saving hematopoietic stem cells. When used in hematopoietic stem cell transplantation, umbilical cord blood offers several distinct advantages over bone marrow or peripheral stem cells. However, umbilical cord blood collection is not part of routine obstetric care and is not medically indicated. Umbilical cord blood collection should not compromise obstetric or neonatal care or alter routine practice for the timing of umbilical cord clamping. If a patient requests information on umbilical cord blood banking, balanced and accurate information regarding the advantages and disadvantages of public and private umbilical cord blood banking should be provided. The routine storage of umbilical cord blood as "biologic insurance" against future disease is not recommended. PMID:26595578

  3. Committee Opinion No. 648: Umbilical Cord Blood Banking.

    PubMed

    2015-12-01

    Once considered a waste product that was discarded with the placenta, umbilical cord blood is now known to contain potentially life-saving hematopoietic stem cells. When used in hematopoietic stem cell transplantation, umbilical cord blood offers several distinct advantages over bone marrow or peripheral stem cells. However, umbilical cord blood collection is not part of routine obstetric care and is not medically indicated. Umbilical cord blood collection should not compromise obstetric or neonatal care or alter routine practice for the timing of umbilical cord clamping. If a patient requests information on umbilical cord blood banking, balanced and accurate information regarding the advantages and disadvantages of public and private umbilical cord blood banking should be provided. The routine storage of umbilical cord blood as "biologic insurance" against future disease is not recommended. PMID:26595583

  4. Paralyzed Man Walks Using Technology That Bypasses Spinal Cord

    MedlinePLUS

    ... html Paralyzed Man Walks Using Technology That Bypasses Spinal Cord Brain signals travel through a computer that sends ... system like this might help people with a spinal cord injury regain some ability to walk, the researchers ...

  5. Unusual cord transection in a patient with traumatic spondylolisthesis

    PubMed Central

    Baliyan, Vinit; Shylendran, Sudhin; Ajay, K. Yadav; Kumar, Atin; Gamanagatti, Shivanand; Sinha, Sumit

    2016-01-01

    Spinal cord injury is one of the most debilitating injuries in patients with spinal trauma. Cord injury may range from simple cord edema to frank transection. Cord transection is the most severe form of cord injury as it results in complete and irreversible loss of all neural functions. Generally, it is a result of unstable spinal fractures with associated spondylolisthesis or spondyloptosis. Generally, the level of cord transection corresponds to the level of spinal fracture/spondylolisthesis. However, here we are presenting a case having a traumatic spinal fracture with spondylolisthesis where the level of cord transection was much higher than the level of the spinal fracture. Due to the traumatic traction, the cord distal to transection is displaced inferior leaving behind a long segment of the empty thecal sac. PMID:26889291

  6. Normalization of central cord syndrome spinal cord injury urodynamics after intrathecal baclofen therapy: a case report.

    PubMed

    Schreiber, Adam L; Fried, Guy W; Formal, Christopher S

    2009-10-01

    Objective.?To report a case of improved urodynamics in a central cord syndrome spinal cord injury after intrathecal baclofen therapy. Methods.?A 47-year-old man fell resulting in C4-C5 disc herniation with ventral spinal cord compression and cord edema. Results.?He underwent an anterior cervical discectomy and fusion. Postoperatively, his examination revealed a C4 ASIA D injury in a central cord syndrome pattern. Cystometrogram (CMG) revealed a hyperactive detrusor with sphincter dyssynergia managed with intermittent self-catheterization. One and a half years later, he was impaired by severe lower limb spasticity, despite oral medications and botulinum toxin injections. After intrathecal pump therapy, CMG revealed relatively normal detrusor and minimal sphincter tone. He volitionally voids with urgency but improved continence, which was maintained in one-year follow-up. Conclusion.?Although the main indication for intrathecal baclofen therapy is spasticity, improved urodynamics can be an additional benefit in central cord syndrome spinal cord injury. PMID:22151422

  7. Kidney donation after cardiac death

    PubMed Central

    Akoh, Jacob A

    2012-01-01

    There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death (DCD) and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to controlled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function (DGF) and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that significantly influences the outcome of allografts, for example, limiting it to < 12 h markedly reduces DGF. DCD kidneys from donors < 50 function like standard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled donation, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kidneys from DCD include: implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function. PMID:24175245

  8. Cannabinoids to treat spinal cord injury.

    PubMed

    Arevalo-Martin, Angel; Molina-Holgado, Eduardo; Garcia-Ovejero, Daniel

    2016-01-01

    Spinal cord injury (SCI) is a devastating condition for which there is no standard treatment beyond rehabilitation strategies. In this review, we discuss the current knowledge on the use of cannabinoids to treat this condition. The endocannabinoid system is expressed in the intact spinal cord, and it is dramatically upregulated after lesion. Endogenous activation of this system counteracts secondary damage following SCI, and treatments with endocannabinoids or synthetic cannabinoid receptor agonists promote a better functional outcome in experimental models. The use of cannabinoids in SCI is a new research field and many questions remain open. Here, we discuss caveats and suggest some future directions that may help to understand the role of cannabinoids in SCI and how to take advantage of this system to regain functions after spinal cord damage. PMID:25805333

  9. Vascular anatomy of the spinal cord

    SciTech Connect

    Thron, A.K.

    1988-01-01

    The book summarizes the anatomic guidelines of external blood supply to the spinal cord. The basic principles of arterial supply and venous drainage are illustrated by explicit schemes for quick orientation. In the first part of the book, systematic radiologic-anatomic investigations of the superficial and deep vessels of all segments of the spinal cord are introduced. The microvascular morphology is portrayed by numerous microradiographic sections in all three dimensions without overshadowing. The three-dimensional representation of the vascular architecture illustrates elementary outlines and details of arterial territories, anastomotic cross-linking as well as the capillary system, particularly the hitherto unknown structure of the medullary venous system with its functionally important anastomoses and varying regional structures. These often now radiologic-anatomic findings are discussed as to their functional and pathophysiologic impact and constitute the basic on which to improve one's understanding of vascular syndromes of the spinal cord.

  10. Radiation-induced spinal cord hemorrhage (hematomyelia).

    PubMed

    Agarwal, Amit; Kanekar, Sangam; Thamburaj, Krishnamurthy; Vijay, Kanupriya

    2014-10-23

    Intraspinal hemorrhage is very rare and intramedullary hemorrhage, also called hematomyelia, is the rarest form of intraspinal hemorrhage, usually related to trauma. Spinal vascular malformations such intradural arteriovenous malformations are the most common cause of atraumatic hematomyelia. Other considerations include warfarin or heparin anticoagulation, bleeding disorders, spinal cord tumors. Radiation-induced hematomyelia of the cord is exceedingly rare with only one case in literature to date. We report the case of an 8 year old girl with Ewing's sarcoma of the thoracic vertebra, under radiation therapy, presenting with hematomyelia. We describe the clinical course, the findings on imaging studies and the available information in the literature. Recognition of the clinical pattern of spinal cord injury should lead clinicians to perform imaging studies to evaluate for compressive etiologies. PMID:25568739

  11. Metastatic Spermatic Cord Tumor From Colorectal Cancer

    PubMed Central

    Jang, Ji Geon; Jeong, Hye Yun; Kim, Ki Soo; Lee, Jin Sook; Kim, Sang Su; Kim, Ho Young

    2015-01-01

    Metastatic tumors of the spermatic cord are extremely rare, and the prognosis for patients is typically poor. In the majority of cases, the primary tumor occurs in the gastrointestinal tract. We report a case of a 62-year-old man with a metastatic spermatic cord tumor. The patient complained of groin discomfort with a tender mass in the right inguinal area. An excisional biopsy was performed, and the pathologic finding was a metastatic mucinous adenocarcinoma. We performed a systemic evaluation including colonoscopy, abdominal computed tomography, and total-body positron emission tomography, and the primary tumor was confirmed to involve the total colon, including the cecum, sigmoid colon, and rectum. The pathologic finding for rectum revealed a mucinous adenocarcinoma compatible with a metastatic spermatic cord tumor. PMID:26576400

  12. Cord blood clinical processing, cryopreservation, and storage.

    PubMed

    Elmoazzen, Heidi; Holovati, Jelena L

    2015-01-01

    Allogeneic umbilical cord blood (UCB) hematopoietic stem cell transplantation has become a crucial advancement in the treatment for a variety of diseases including hematopoietic and non-hematopoietic malignancies, BM failure syndromes, hemoglobinopathies, and metabolic and immunodeficiency disorders. It has been well documented that the success of UCB engraftment is tied to UCB banking processes, and now there are established guidelines for standardization of collection, banking, processing, and cryopreservation for unrelated UCB units with purpose of achieving consistent production of high quality placental and UCB units for administration. In 2011, Canada's Ministry of Health has announced Canada's first national, publicly funded umbilical cord blood bank, which aims to provide altruistic donations for unrelated allogeneic hematopoietic stem cell transplant. In this chapter, we describe specific protocols for clinical processing, cryopreservation, and storage of UCB used by the Canadian Blood Services National Public Umbilical Cord Blood Bank. PMID:25428018

  13. Absorbable gelatin powder injection for transient vocal cord paralysis.

    PubMed

    Miller, M A; Saltvoll, B

    1995-05-01

    In the early 1900s, glottic insufficiency in patients with vocal cord paralysis was corrected by injecting paraffin intralaryngeally. Since then, injecting absorbable gelatin powder into the vocal cord has become an acceptable short-term solution for transient paralysis of a single vocal cord. Although relatively uncommon, this procedure has few complications and is an option for patients when vocal cord function is expected to return within one year. PMID:7611738

  14. Highly accurate volumetry of the spinal cord

    NASA Astrophysics Data System (ADS)

    Weiler, Florian; Daams, Marita; Lukas, Carsten; Barkhof, Frederik; Hahn, Horst K.

    2015-03-01

    Quantitative analysis of the spinal cord from MR images is of significant clinical interest when studying certain neurologic diseases. Especially for multiple sclerosis, a number of studies have analyzed the relation between spinal cord atrophy and clinically monitored progression of the disease. A commonly analyzed parameter in this field is the mean cross-sectional area of the cord, which can also be expressed as the average volume per cm. In this paper, we present a novel approach for precise measurement of the volume, length, and cross-sectional area of the spinal cord from T1-weighted MR images. It is computationally fast, with a low effort of required user interaction. It is based on a semi-automated pre-segmentation of a sub-section of the spinal cord, followed by an automated Gaussian mixture-model fit for volume calculation. Additionally, the centerline of the cord is extracted, which allows for calculation of the mean cross-sectional area of the measured section. We evaluate the accuracy of our method with respect to scan/re-scan reproducibility as well as intra- and inter-rater agreement. We achieved a mean coefficient of variation of 0.62% over repeated MR acquisitions, mean CoV of 0.39% for intra-rater comparison, and a mean CoV of 0.28% for inter-rater comparison by five different observers. These results prove a high sensitivity to detect even small changes in atrophy, as it could typically be observed over the temporal progression of MS

  15. Umbilical Cord Coiling Index and Perinatal Outcome

    PubMed Central

    Patil, Nivedita S.; Kulkarni, Sunanda R.; Lohitashwa, Renu

    2013-01-01

    Objectives: To evaluate the perinatal outcome with the abnormal umbilical cord coiling index. Study Design: This prospective study was carried out in the department of OBG at Adichunchangiri Institute of Medical Sciences, B.G.Nagara, Mandya, Karnataka, India from January 2008 to August 2010. 200 patients who were in active labour with term gestations, irrespective of their parities, who had singleton pregnancies with live babies who were either delivered by vaginal or LSCS were included in the study. Umbilical cord coiling index was calculated and it was correlated with various perinatal parameters like birth weight, meconium stained liquor, Apgar score, ponderal index and foetal growth restriction. Chi square and Fisher exact tests were used to find the significance of study parameters. Results: There was a significant correlation between the hypercoiled cords (UCI >90th percentile) and IUGR of the babies (p value of < 0.001) and low ponderal indices (a p value of 0.022) Hypocoiled cords ( UCI which was < 10th percentile) were significantly associated with meconium staining (p < 0.001), Apgar score at 1 min of <4 and at 5 min of <7 (p value 0.065), LSCS rates (p value of 0.008) and NICU admissions (p <0.001). Conclusion: Hypercoiled cords or UCI which was > 90th percentile was associated with IUGR and low ponderal indices. Hypocoiled cords or UCI which was <10th percentile was associated with meconium staining, Apgar score at 1 min of <4 and at 5 min of <7, more LSCS rates and more NICU admissions. PMID:24086872

  16. Pathologic approach to spinal cord infections.

    PubMed

    Tihan, Tarik

    2015-05-01

    The pathologic evaluation of spinal cord infections requires comprehensive clinical, radiological, and laboratory correlation, because the histologic findings in acute, chronic, or granulomatous infections rarely provide clues for the specific cause. This brief review focuses on the pathologic mechanisms as well as practical issues in the diagnosis and reporting of infections of the spinal cord. Examples are provided of the common infectious agents and methods for their diagnosis. By necessity, discussion is restricted to the infections of the medulla spinalis proper and its meninges, and not bone or soft tissue infections. PMID:25952171

  17. The benefits of optimal cord clamping.

    PubMed

    Busellato, Lisa; Bayes, Sara

    2016-01-01

    Optimal cord clamping is known and now widely recognised as having positive consequences for the neonate in the short- and medium-term. This review of some of the key literature published over the last five years on the effects of both ECC and OCC provides an insight into the evidence on this topic. The aim of this article is to summarise the key papers on the topic of the effect of timing of cord clamping, including some of those included in the Cochrane Review as well as the majority that have been published since, to provide an up-to-date overview. PMID:26975125

  18. Perspectives on implementing delayed cord clamping.

    PubMed

    Leslie, Mayri Sagady

    2015-01-01

    Expanding evidence supports delayed cord clamping (DCC) for both term and preterm infants. This article explores issues that may be keeping early cord clamping (ECC) in place as usual practice. Professional organizations almost universally recommend DCC for preterm infants, but some reserve recommending it for term infants only in resource-poor settings. Concerns about polycythemia and jaundice persist in the literature, while years of published randomized controlled trials do not support the assumptions behind the concerns. New data suggest that DCC may improve resuscitative efforts in compromised infants. Multiple perspectives are offered for consideration when thinking about incorporating DCC into practice. PMID:25900587

  19. Spinal cord monitoring in neuromuscular scoliosis.

    PubMed

    Tucker, S K; Noordeen, M H; Pitt, M C

    2001-01-01

    This article reviews the use of spinal cord monitoring in neuromuscular scoliosis, a condition having a higher incidence of true positive results than idiopathic scoliosis. While somatosensory cortical evoked potentials (SCEP) are unreliable, somatosensory spinal evoked potentials (SSEP) are possible to obtain in most cases and a method using an epidural electrode is described. The '50% rule' is satisfactory having good specificity and sensitivity with it rare for post-operative paralysis to have occurred undetected. The spinal cord in these cases appears to have increased susceptibility particularly during the passage of sublaminar wires with the incidence of complications reduced using modern instrumentation. PMID:11269804

  20. 30 CFR 18.35 - Portable (trailing) cables and cords.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Portable (trailing) cables and cords. 18.35... and Design Requirements 18.35 Portable (trailing) cables and cords. (a) Portable cables and cords... a portable (trailing) cable shall not exceed 500 feet. Where the method of mining requires...

  1. 30 CFR 18.35 - Portable (trailing) cables and cords.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Portable (trailing) cables and cords. 18.35... and Design Requirements 18.35 Portable (trailing) cables and cords. (a) Portable cables and cords... a portable (trailing) cable shall not exceed 500 feet. Where the method of mining requires...

  2. 30 CFR 18.35 - Portable (trailing) cables and cords.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Portable (trailing) cables and cords. 18.35... and Design Requirements 18.35 Portable (trailing) cables and cords. (a) Portable cables and cords... a portable (trailing) cable shall not exceed 500 feet. Where the method of mining requires...

  3. 30 CFR 18.35 - Portable (trailing) cables and cords.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Portable (trailing) cables and cords. 18.35... and Design Requirements 18.35 Portable (trailing) cables and cords. (a) Portable cables and cords... a portable (trailing) cable shall not exceed 500 feet. Where the method of mining requires...

  4. Turkish Adaptation of Spinal Cord Independence Measure--Version III

    ERIC Educational Resources Information Center

    Kesiktas, Nur; Paker, Nurdan; Bugdayci, Derya; Sencan, Sureyya; Karan, Ayse; Muslumanoglu, Lutfiye

    2012-01-01

    Various rating scales have been used to assess ability in individuals with spinal cord injury. There is no specific functional assessment scale for Turkish patients with spinal cord injury. The Spinal Cord Independence Measure (SCIM) is a specific test, which has become popular in the last decade. A study was conducted to validate and evaluate the…

  5. Sexuality Counseling with Clients Who Have Spinal Cord Injuries.

    ERIC Educational Resources Information Center

    Farrow, Jeff

    1990-01-01

    Examines effects of spinal cord injury on sexuality. Discusses areas of sexual concern. Provides suggestions for treating clients with spinal cord injuries experiencing sexual difficulties. Concludes that major goal in working with clients with spinal cord injuries who have sexual difficulties should be the facilitation of a creative and…

  6. 30 CFR 18.35 - Portable (trailing) cables and cords.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Portable (trailing) cables and cords. 18.35... and Design Requirements § 18.35 Portable (trailing) cables and cords. (a) Portable cables and cords... conductor of a current-carrying capacity consistent with the Insulated Power Cable Engineers...

  7. Sexuality Counseling with Clients Who Have Spinal Cord Injuries.

    ERIC Educational Resources Information Center

    Farrow, Jeff

    1990-01-01

    Examines effects of spinal cord injury on sexuality. Discusses areas of sexual concern. Provides suggestions for treating clients with spinal cord injuries experiencing sexual difficulties. Concludes that major goal in working with clients with spinal cord injuries who have sexual difficulties should be the facilitation of a creative and

  8. Turkish Adaptation of Spinal Cord Independence Measure--Version III

    ERIC Educational Resources Information Center

    Kesiktas, Nur; Paker, Nurdan; Bugdayci, Derya; Sencan, Sureyya; Karan, Ayse; Muslumanoglu, Lutfiye

    2012-01-01

    Various rating scales have been used to assess ability in individuals with spinal cord injury. There is no specific functional assessment scale for Turkish patients with spinal cord injury. The Spinal Cord Independence Measure (SCIM) is a specific test, which has become popular in the last decade. A study was conducted to validate and evaluate the

  9. Characteristics and rehabilitation for patients with spinal cord stab injury

    PubMed Central

    Wang, Fangyong; Zhang, Junwei; Tang, Hehu; Li, Xiang; Jiang, Shudong; Lv, Zhen; Liu, Shujia; Chen, Shizheng; Liu, Jiesheng; Hong, Yi

    2015-01-01

    [Purpose] The objective of the study was to compare the incidence, diagnosis, treatment, and prognosis of patients with spinal cord stab injury to those with the more common spinal cord contusion injury. [Subjects] Of patients hospitalized in China Rehabilitation Research Center from 1994 to 2014, 40 of those having a spinal cord stab injury and 50 with spinal cord contusion were selected. [Methods] The data of all patients were analyzed retrospectively. The cases were evaluated by collecting admission and discharge ASIA (American Spinal Injury Association) and ADL (activity of daily living) scores. [Results] After a comprehensive rehabilitation program, ASIA and ADL scores of patients having both spinal cord stab injury and spinal cord contusion significantly increase. However, the increases were noted to be higher in patients having a spinal cord stab injury than those having spinal cord contusion. [Conclusion] Comprehensive rehabilitation is effective both for patients having spinal cord stab injury and those with spinal cord contusion injury. However, the prognosis of patients having spinal cord stab injury is better than that of patients with spinal cord contusion. PMID:26834329

  10. Untethering an unusual cause of kidney injury in a teenager with Down syndrome.

    PubMed

    Yen, Elizabeth; Miele, Niel F; Barone, Joseph G; Tyagi, Rachana; Weiss, Lynne S

    2014-11-01

    Acute kidney injury (AKI) is characterized by the acute nature and the inability of kidneys to maintain fluid homeostasis as well as adequate electrolyte and acid-base balance, resulting in an accumulation of nitrogenous waste and elevation of serum blood urea nitrogen and creatinine values. Acute kidney injury may be a single isolated event, yet oftentimes, it results from an acute chronic kidney disease. It is critical to seek out the etiology of AKI and to promptly manage the underlying chronic kidney disease to prevent comorbidities and mortality that may ensue. We described a case of a 16-year-old adolescent girl with Down syndrome who presented with AKI and electrolyte aberrance.Abdominal and renal ultrasounds demonstrated a significantly dilated bladder as well as frank hydronephrosis and hydroureter bilaterally. Foley catheter was successful in relieving the obstruction and improving her renal function. However, a magnetic resonance imaging was pursued in light of her chronic constipation and back pain, and it revealed a structural defect (tethered cord) that underlies a chronic process that was highly likely contributory to her AKI. She was managed accordingly with a guarded result and required long-term and close monitoring. PMID:25373571

  11. Biomarkers in chronic kidney disease, from kidney function to kidney damage

    PubMed Central

    Lopez-Giacoman, Salvador; Madero, Magdalena

    2015-01-01

    Chronic kidney disease (CKD) typically evolves over many years, with a long latent period when the disease is clinically silent and therefore diagnosis, evaluation and treatment is based mainly on biomarkers that assess kidney function. Glomerular filtration rate (GFR) remains the ideal marker of kidney function. Unfortunately measuring GFR is time consuming and therefore GFR is usually estimated from equations that take into account endogenous filtration markers like serum creatinine (SCr) and cystatin C (CysC). Other biomarkers such as albuminuria may precede kidney function decline and have demonstrated to have strong associations with disease progression and outcomes. New potential biomarkers have arisen with the promise of detecting kidney damage prior to the currently used markers. The aim of this review is to discuss the utility of the GFR estimating equations and biomarkers in CKD and the different clinical settings where these should be applied. The CKD-Epidemiology Collaboration equation performs better than the modification of diet in renal disease equation, especially at GFR above 60 mL/min per 1.73 m2. Equations combining CysC and SCr perform better than the equations using either CysC or SCr alone and are recommended in situations where CKD needs to be confirmed. Combining creatinine, CysC and urine albumin to creatinine ratio improves risk stratification for kidney disease progression and mortality. Kidney injury molecule and neutrophil gelatinase-associated lipocalin are considered reasonable biomarkers in urine and plasma to determine severity and prognosis of CKD. PMID:25664247

  12. FastStats: Kidney Disease

    MedlinePLUS

    ... Mental Health Diabetes Digestive and Liver Digestive Diseases Chronic Liver Disease and Cirrhosis Kidney Disease Oral and Dental Health Respiratory and Allergies Allergies and Hay Fever Asthma Chronic Obstructive Pulmonary Disease Infectious/Immune AIDS and HIV ...

  13. Pyelonephritis (Kidney Infection) in Adults

    MedlinePLUS

    ... scans use a combination of x rays and computer technology to create three-dimensional (3-D) images. ... the body to the kidneys. Special cameras and computers are used to create images of the radioactive ...

  14. 10 Symptoms of Kidney Disease

    MedlinePLUS

    ... were so big I couldn't get my shoes on." "My sister, her hair started to fall ... do anything, just totally drained." Symptom 4: Skin Rash/Itching Kidneys remove wastes from the bloodstream. When ...

  15. Adiponectin effects on the kidney

    PubMed Central

    Sweiss, Natalie; Sharma, Kumar

    2014-01-01

    Adiponectin is a 30-kDa polypeptide secreted primarily by adipose tissue and plays a key role in kidney disease. In obesity, reduced adiponectin levels are associated with insulin resistance, cardiovascular disease and obesity related kidney disease. The latter includes microalbuminuria, glomerulomegaly, overt proteinuria and focal segmental glomerulosclerosis. Adiponectin levels in type 2 diabetics also negatively correlate with early features of nephropathy. However, in patients with established chronic kidney disease, adiponectin levels are elevated and positively predict progression of disease. The mechanism of action of adiponectin in the kidney appears to be related to AMPK activation and NADPH oxidase. Further studies are needed to elucidate this pathway and investigate the role of potential targets of adiponectin-AMPK-Nox pathway for CKD as obesity-related CKD is increasing worldwide. PMID:24417947

  16. The kidney tight junction (Review)

    PubMed Central

    HOU, JIANGHUI

    2014-01-01

    The tight junction is an important subcellular organelle which plays a vital role in epithelial barrier function. Claudin, as the integral membrane component of tight junctions, creates a paracellular transport pathway for various ions to be reabsorbed by the kidneys. This review summarizes advances in claudin structure, function and pathophysiology in kidney diseases. Different claudin species confer selective paracellular permeability to each of three major renal tubular segments: the proximal tubule, the thick ascending limb of Henle’s loop and the distal nephron. Defects in claudin function can cause a wide spectrum of kidney diseases, such as hypomagnesemia, hypercalciuria, kidney stones and hypertension. Studies using transgenic mouse models with claudin mutations have recapitulated several of these renal disease phenotypes and have elucidated the underlying biological mechanisms. Modern recording approaches based upon scanning ion conductance microscopy may resolve the biophysical nature of claudin transport function and provide novel insight into tight junction architecture. PMID:25319473

  17. Diabetes and Chronic Kidney Disease

    MedlinePLUS

    ... Diabetes is the leading cause of kidney failure, accounting for 44% percent of new cases. Current research ... more common than type 1 (insulin-dependent diabetes), accounting for about 90 to 95 percent of the ...

  18. [Iatrogenic kidney diseases].

    PubMed

    Rutkowski, Boles?aw

    2010-01-01

    Iatrogenic kidney diseases may appeared as the consequence of medical mistakes or as the result of drug side effects. Present paper is dedicated mainly to this second group of disorders. Spectrum of different syndromes caused by the undesirable drug effects is very long and varied. There are among them water and electrolyte, disorders, tubulo-interstitial nephritis, glomerulopathies or acute renal failure. Also list of potentially nephrotoxic drugs is very long and including many different medicines. Additionally it is important to take into account existence of many risk factors enabling appearance of drug nephrotoxicity. Most important seen to be advanced age and deterioration of renal function. Main prophylactic method preventing development of drug induced nephropaties is strict drug dosage, their adjustment according glomerular filtration rate and monitoring of water- electrolyte balance. Common automatic estimation of eGFR by diagnostic laboratories have to be useful tool in this matter. It is also important to avoid combinations of potentially nephrotoxic drugs. In case of the appearance of first symptoms of toxic renal injury specific activities dependent from the character and severity of pathological changes are necessary. Nevertheless most important issue is consciousness of this danger in both sides: physician and patients enabling avoid drug nephrotoxicity. PMID:20369729

  19. Kidney epithelial cells.

    PubMed

    Smith, Peter L; Buffington, Deborah A; Humes, H David

    2006-01-01

    Kidney tubules are an essential component of an organism's blood clearance mechanism, recovering essential metabolites from glomerular filtration by active transport. Tubules are subject to injury, usually as the result of ischemia-reperfusion events that damage the polarized tubular cell layer that coats the tubule basement membrane, causing dysfunction and necrosis that is often associated with acute renal failure. However, tubules are capable of self-repair, forming new proximal tubular cells to replace failing or necrotic cells. The origin of the progenitor cells that give rise to new tubular cells is unknown. At one extreme, it is possible that all or a fraction of tubular cells can undergo a form of dedifferentiation and subsequent mitosis to form new tubular cells, or alternatively, it is possible that tubular regeneration follows the stem cell/transit-amplifying cell paradigm described for more rapidly regenerating organ systems. Regardless of the mechanism employed to generate new tubular cells, human tubular cells are readily grown in primary cultures and can recapitulate many of the metabolic, endocrine, and immunological properties attributable to endogenous renal proximal tubules when engrafted into bioartificial devices. PMID:17141057

  20. Stress and the kidney.

    PubMed

    Bruce, Marino A; Griffith, Derek M; Thorpe, Roland J

    2015-01-01

    The prevalence of CKD has increased considerably over the past 2 decades. The rising rates of CKD have been attributed to known comorbidities such as diabetes, hypertension, and obesity; however, recent research has begun to explore the degree to which social, economic, and psychological factors have implications for the prevalence and progression of CKD, especially among high-risk populations such as African Americans. It has been suggested that stress can have implications for CKD, but this area of research has been largely unexplored. One contributing factor associated with the paucity of research on CKD is that many of the social, psychological, and environmental stressors cannot be recreated or simulated in a laboratory setting. Social science has established that stress can have implications for health, and we believe that stress is an important determinant of the development and progression of CKD. We draw heavily from the social scientific and social epidemiologic literature to present an intersectional conceptual frame specifying how stress can have implications for kidney disease, its progression, and its complications through multiple stressors and pathways. PMID:25573512

  1. The three-kidney rat

    SciTech Connect

    Provoost, A.P.; Van Aken, M.

    1984-01-01

    In contrast to the numerous research into the adaption of renal function when nephons are lost, much less attention has been paid to the effects of an extra kidney. Through the availability of inbred rat strains, techniques to transplant rat kidneys, and methods to measure total and individual kidney function repeatedly in the same animal, it became possible to study the renal function in rats with three kidneys. Adult male rats of a highly inbred Wistar strain were used. Nine recipients of a third kidney (3-K) were compared with 5 sham operated control (2-K) rats. The total GFR, as measured by the plasma clearance of Cr-5l EDTA, was taken 1,3,6,9, and 15 weeks after operation. The contribution of each kidney to the total renal function was determined by a Tc-99m DTPA scan performed at weeks 10 and 16. After transplantation the total GFR of 3-K rats was, in general, not different from the value before transplantation or from that of 2-K rats. The lack of increase of the GFR of 3-K rats was not the result of a non-functioning graft.

  2. Thirteen cases of liver-kidney transplantation.

    PubMed

    Gonzlez, M R; Ramrez, P; Cascales, P; Domingo, J; Lpez, M D; Rios, A; Snchez, F; Robles, R; Parrilla, P

    2010-10-01

    Combined kidney-liver transplantation is currently the best therapeutic option for patients with end-stage kidney and liver disease. We present our experience of kidney-liver transplantation in a series of 13 patients. The most frequent indications were familial amyloidotic polyneuropathy (FAP) and polycystosis of the liver and kidney. The 1- and 5-year survival rates of the liver grafts were 75% and 67%, respectively, with no kidney losses during follow-up. PMID:20970636

  3. Spinal cord compression following traditional confinement massage.

    PubMed

    Sahathevan, R; Tan, H J; Abdullah, Suhail; Shahizon, A M M; Hamidon, B B; Raymond, A A

    2011-12-01

    We describe a case of tetraparesis in a 33-year-old woman following neck manipulation performed by a traditional confinement mid-wife. An MRI of the cervical spine revealed a fracture of the second cervical vertebra with atlanto-axial subluxation that resulted in cord compression. PMID:22390109

  4. Employment Outcomes Following Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Engel, S.; Murphy, G. S.; Athanasou, J. A.; Hickey, L.

    1998-01-01

    A study of 83 Australian adults with spinal cord injuries found that at least 56% had worked at some time post-injury and those who were working when surveyed had done so for an average of close to 10 years. Clerical, office, and administrative occupations proved to be the most suitable. (Author/CR)

  5. Accommodating Workers with Spinal Cord Injury.

    ERIC Educational Resources Information Center

    Dowler, Denetta; Batiste, Linda; Whidden, Eddie

    1998-01-01

    Examination of over 1,000 calls to the Job Accommodation Network involving workers with spinal cord injury identified the nature of the industry, job, career progression, and accessibility solutions. The number of calls increased dramatically after passage of the Americans with Disabilities Act. (SK)

  6. Treatment of early stage vocal cord carcinoma

    SciTech Connect

    Ayers, G.

    1989-03-01

    The cure rates for early stage vocal cord cancer are excellent with primary radiotherapy. Voice quality remains as good or becomes better than prior to treatment. For the local failures that do occur, surgical salvage will yield ultimate cure rates of about 95% for T1 and 90% for T2 tumors.

  7. Differentiation of idiopathic spinal cord herniation from CSF-isointense intraspinal extramedullary lesions displacing the cord.

    PubMed

    Haber, Marc D; Nguyen, Dustin D; Li, Shan

    2014-01-01

    Focal spinal cord displacement can be caused by idiopathic spinal cord herniation (ISCH), in which the cord protrudes through a dural defect into the epidural space, causing cord displacement and tethering. ISCH is uncommon and often is misdiagnosed initially, which results in delayed management. ISCH can be mimicked by space-occupying cerebrospinal fluid (CSF)-isointense intraspinal extramedullary lesions, such as epidermoid cysts or teratomas, intradural arachnoid cysts, epidural hematomas or abscesses, cystic nerve sheath tumors, synovial or Tarlov cysts, meningoceles, and pseudomeningoceles. Initial computed tomography (CT) and unenhanced magnetic resonance (MR) imaging studies may depict focal cord displacement and a widened CSF space but often are not sufficient to identify the underlying cause. High-resolution thin-section MR imaging can delineate the exact location of the dural defect and the protrusion of the herniated cord through this defect into the epidural space. At imaging, unimpeded CSF pulsation artifacts seen within a widened CSF space exclude a space-occupying lesion. A filling defect seen at conventional or CT myelography can help confirm a CSF-isointense space-occupying lesion; intravenous contrast agent administration can help exclude a rim-enhancing cystic extramedullary lesion. The clinical presentation usually is nonspecific, but symptom acuity, fever, and trauma can guide the imaging evaluation and help narrow the differential diagnosis. A multimodality imaging approach is essential to differentiate ISCH from space-occupying CSF-isointense intraspinal extramedullary lesions. PMID:24617681

  8. Differentiation of idiopathic spinal cord herniation from CSF-isointense intraspinal extramedullary lesions displacing the cord.

    TOXLINE Toxicology Bibliographic Information

    Haber MD; Nguyen DD; Li S

    2014-03-01

    Focal spinal cord displacement can be caused by idiopathic spinal cord herniation (ISCH), in which the cord protrudes through a dural defect into the epidural space, causing cord displacement and tethering. ISCH is uncommon and often is misdiagnosed initially, which results in delayed management. ISCH can be mimicked by space-occupying cerebrospinal fluid (CSF)-isointense intraspinal extramedullary lesions, such as epidermoid cysts or teratomas, intradural arachnoid cysts, epidural hematomas or abscesses, cystic nerve sheath tumors, synovial or Tarlov cysts, meningoceles, and pseudomeningoceles. Initial computed tomography (CT) and unenhanced magnetic resonance (MR) imaging studies may depict focal cord displacement and a widened CSF space but often are not sufficient to identify the underlying cause. High-resolution thin-section MR imaging can delineate the exact location of the dural defect and the protrusion of the herniated cord through this defect into the epidural space. At imaging, unimpeded CSF pulsation artifacts seen within a widened CSF space exclude a space-occupying lesion. A filling defect seen at conventional or CT myelography can help confirm a CSF-isointense space-occupying lesion; intravenous contrast agent administration can help exclude a rim-enhancing cystic extramedullary lesion. The clinical presentation usually is nonspecific, but symptom acuity, fever, and trauma can guide the imaging evaluation and help narrow the differential diagnosis. A multimodality imaging approach is essential to differentiate ISCH from space-occupying CSF-isointense intraspinal extramedullary lesions.

  9. Effect of gamma irradiation on the properties of tyre cords

    NASA Astrophysics Data System (ADS)

    Ayta, Ay?e; ?en, Murat; Deniz, Veli; Gven, Olgun

    2007-12-01

    Gamma irradiation of high tenacity Nylon 6.6 (Ny 66) and polyester (PET) tyre cords was investigated. The untreated and treated tyre cords with different twist levels were irradiated at different dose rates in air. The effects of irradiation on both Ny 66 and PET cords were not found to be depending on the twist levels of the cords. The changes in the mechanical and thermal properties with absorbed dose at two different dose rates were measured. The mechanical properties were observed to deteriorate with increasing dose for Ny 66 cords, whereas remained almost unchanged for PET cords both in greige and dipped forms. Hot shrinkage value for the greige Ny 66 cords was found to be improved, i.e. decreased. This decrease was much lower for greige PET than Ny 66 cords. It is concluded that PET cord has higher radiation resistance than Ny 66 cord and the effects of high energy irradiation on tyre cords have to be taken into consideration during tyre design if pre-vulcanization with high energy radiation is to be applied.

  10. In-vivo spinal cord deformation in flexion

    NASA Astrophysics Data System (ADS)

    Yuan, Qing; Dougherty, Lawrence; Margulies, Susan S.

    1997-05-01

    Traumatic mechanical loading of the head-neck complex results cervical spinal cord injury when the distortion of the cord is sufficient to produce functional or structural failure of the cord's neural and/or vascular components. Characterizing cervical spinal cord deformation during physiological loading conditions is an important step to defining a comprehensive injury threshold associated with acute spinal cord injury. In this study, in vivo quasi- static deformation of the cervical spinal cord during flexion of the neck in human volunteers was measured using magnetic resonance (MR) imaging of motion with spatial modulation of magnetization (SPAMM). A custom-designed device was built to guide the motion of the neck and enhance more reproducibility. the SPAMM pulse sequence labeled the tissue with a series of parallel tagging lines. A single- shot gradient-recalled-echo sequence was used to acquire the mid-sagittal image of the cervical spine. A comparison of the tagged line pattern in each MR reference and deformed image pair revealed the distortion of the spinal cord. The results showed the cervical spinal cord elongates during head flexion. The elongation experienced by the spinal cord varies linearly with head flexion, with the posterior surface of the cord stretching more than the anterior surface. The maximal elongation of the cord is about 12 percent of its original length.

  11. Umbilical cord cell banking-implications for the future

    SciTech Connect

    Gunning, Jennifer . E-mail: gunning@cf.ac.uk

    2005-09-01

    The first successful cord cell transplant to a sibling with Fanconi's anaemia took place 15 years ago. This proven utility of cord blood led to the establishment of cord blood banks both private and public and there are now nearly 100 cord blood banks worldwide. It is estimated that over 200,000 cord blood units (CBU) are held by the private sector and over 160,000 CBU are registered with the largest public cord blood registry. There is a tension between private cord blood banks, which store CBU for autologous or family use, and public banks, which store CBU for unrelated use and the ethics of private cord blood storage has been questioned. But more general ethical questions also arise regarding ownership, consent, confidentiality, costs and quality standards and patenting. In looking at these ethical issues one also needs to look at potential future use of cord blood stem cells. Up until now cord cells have principally been used in the treatment of paediatric blood and immune disorders. Improvements in cell expansion technology will make CBU more appropriate also for treating adults with such disorders. However, it has also been demonstrated that cord blood stem cells have the capacity to differentiate into other types of cells, neuronal, bone, epithelial and muscle which would have a future role to play in cell therapy and regenerative medicine.

  12. Perioperative acute kidney injury.

    PubMed

    Goren, O; Matot, I

    2015-12-01

    Perioperative acute kidney injury (AKI) is not uncommon and is associated with considerable morbidity and mortality. Recently, several definition systems for AKI were proposed, incorporating both small changes of serum creatinine and urinary output reduction as diagnostic criteria. Novel biomarkers are under investigation as fast and accurate predictors of AKI. Several special considerations regarding the risk of AKI are of note in the surgical patient. Co-morbidities are important risk factors for AKI. The surgery in itself, especially emergency and major surgery in the critically ill, is associated with a high incidence of AKI. Certain types of surgeries, such as cardiac and transplantation surgeries, require special attention because they carry higher risk of AKI. Nephrotoxic drugs, contrast dye, and diuretics are commonly used in the perioperative period and are responsible for a significant amount of in-hospital AKI. Before surgery, the anaesthetist is required to identify patients at risk of AKI, optimize anaemia, and treat hypovolaemia. During surgery, normovolaemia is of utmost importance. Additionally, the surgical and anaesthesia team is advised to use measures to reduce blood loss and avoid unnecessary blood transfusion. Hypotension should be avoided because even short periods of mean arterial pressure <55-60 mm Hg carry a risk of postoperative AKI. Higher blood pressures are probably required for hypertensive patients. Urine output can be reduced significantly during surgery and is unrelated to perioperative renal function. Thus, fluids should not be given in excess for the sole purpose of avoiding or treating oliguria. Use of hydroxyethyl starch needs to be reconsidered. Recent evidence indicates a beneficial effect of administering low-chloride solutions. PMID:26658199

  13. Imatinib enhances functional outcome after spinal cord injury.

    PubMed

    Abrams, Mathew B; Nilsson, Ingrid; Lewandowski, Sebastian A; Kjell, Jacob; Codeluppi, Simone; Olson, Lars; Eriksson, Ulf

    2012-01-01

    We investigated whether imatinib (Gleevec, Novartis), a tyrosine kinase inhibitor, could improve functional outcome in experimental spinal cord injury. Rats subjected to contusion spinal cord injury were treated orally with imatinib for 5 days beginning 30 minutes after injury. We found that imatinib significantly enhanced blood-spinal cord-barrier integrity, hindlimb locomotor function, sensorimotor integration, and bladder function, as well as attenuated astrogliosis and deposition of chondroitin sulfate proteoglycans, and increased tissue preservation. These improvements were associated with enhanced vascular integrity and reduced inflammation. Our results show that imatinib improves recovery in spinal cord injury by preserving axons and other spinal cord tissue components. The rapid time course of these beneficial effects suggests that the effects of imatinib are neuroprotective rather than neurorestorative. The positive effects on experimental spinal cord injury, obtained by oral delivery of a clinically used drug, makes imatinib an interesting candidate drug for clinical trials in spinal cord injury. PMID:22723886

  14. Simplified spinal cord phantom for evaluation of SQUID magnetospinography

    NASA Astrophysics Data System (ADS)

    Adachi, Y.; Oyama, D.; Somchai, N.; Kawabata, S.; Uehara, G.

    2014-05-01

    Spinal cord functional imaging by magnetospinography (MSG) is a noninvasive diagnostic method for spinal cord diseases. However, the accuracy and spatial resolution of lesion localization by MSG have barely been evaluated in detail so far. We developed a simplified spinal cord phantom for MSG evaluation. The spinal cord phantom is composed of a cylindrical vessel filled with saline water, which acts as a model of a neck. A set of modeled vertebrae is arranged in the cylindrical vessel, which has a neural current model made from catheter electrodes. The neural current model emulates the current distribution around the activated site along the axon of the spinal cord nerve. Our MSG system was used to observe the magnetic field from the phantom; a quadrupole-like pattern of the magnetic field distribution, which is a typical distribution pattern for spinal cord magnetic fields, was successfully reproduced by the phantom. Hence, the developed spinal cord phantom can be used to evaluate MSG source analysis methods.

  15. [Kidney donors and kidney transplantation in the elderly].

    PubMed

    Giessing, M; Conrad, S; Schönberger, B; Huland, H; Budde, K; Neumayer, H-H; Loening, S A

    2004-08-01

    The likelihood of terminal renal insufficiency escalates with age, increasing the risk of dying as a patient requiring dialysis. In 1999, Eurotransplant initiated the Eurotransplant Senior Programm (ESP), in which the kidneys of old donors (>64 years) are allocated to recipients 64 years and older. Allocation does not take HLA-matching into account and is performed regionally only according to blood-group-compatibility to keep the storage time short. As a consequence of the short ischemic time, and thus reduced non-immunological damage to the anyways susceptible old kidney, graft-function and graft-survival in the ESP are very good. The results of the initial 5 years of this program show that it successfully utilizes more kidneys from old donors and that more old recipients are being transplanted, with a satisfactory graft-function. Increased donor- and/or recipient age require a thorough evaluation to exclude malignant and other diseases. Furthermore, short term controls on the waiting list and following kidney transplantation are prerequisites for successful transplantation in the aged recipient. If this is guaranteed, kidney transplantation in the old recipient-even with old donor organs-is a good alternative to the morbidity of a prolonged dialysis. Nevertheless, the role of HLA-matching should be reconsidered to reduce rejections. PMID:15249962

  16. Multiple sclerosis of the spinal cord: Magnetic resonance appearance

    SciTech Connect

    Thielen, K.R.; Miller, G.M.

    1996-05-01

    To determine the MR appearance of spinal cord multiple sclerosis (MS) plaques in patients presenting with myclopathy by using a high-field (1.5 T) imager. We studied 119 patients who underwent high-field (1.5 T) MR studies of the spinal cord for evaluation of myelopathy. All 119 patients were thought to have possible findings of spinal cord MS at the time of the MRI interpretation. Sixty-four plaques were studied in 47 patients with clinically definite MS and adequate quality MRI. Of these patients 68% had a single spinal cord plaque, 19% had two plaques, and 13% had three or more plaques. Sixty-two percent of the plaques occurred in the cervical spinal cord and most frequently involved the posterior (41%) and lateral (25%) aspects of the spinal cord. None of the 64 lesions involved the entire thickness of the spinal cord. The lesion length varied from 2 to 60 mm, with 84% of the lesions <15 mm in length. The spinal cord diameter was unchanged in 84% of plaques, enlarged at the level of the lesion in 14%, and atrophic in 2%. Just over half (55%) of the plaques enhanced with intravenously administered gadolinium. Of the patients who received synchronous head and spinal cord examinations on the same day, 24% had normal findings on the MR study of the head. Follow-up spinal cord studies were available in nine patients. New lesions developed in two patients, while previously described lesions resolved. In three patients only new lesions developed. In four patients no change occurred in the existing number of cord plaques. Spinal cord demyelinating plaques present as well-circumscribed foci of increased T2 signal that asymmetrically involve the spinal cord parenchyma. Knowledge of their usual appearance may prevent unnecessary biopsy. An MR examination of the head may confirm the imaging suggestion of spinal cord demyelinating disease, because up to 76% of patients have abnormal intracranial findings. 15 refs., 7 figs.

  17. Hereditary Causes of Kidney Stones and Chronic Kidney Disease

    PubMed Central

    Edvardsson, Vidar O.; Goldfarb, David S.; Lieske, John C.; Beara-Lasic, Lada; Anglani, Franca; Milliner, Dawn S.; Palsson, Runolfur

    2013-01-01

    Adenine phosphoribosyltransferase (APRT) deficiency, cystinuria, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) and primary hyperoxaluria (PH) are rare but important causes of severe kidney stone disease and/or chronic kidney disease in children. Recurrent kidney stone disease and nephrocalcinosis, particularly in pre-pubertal children, should alert the physician to the possibility of an inborn error of metabolism as the underlying cause. Unfortunately, the lack of recognition and knowledge of the five disorders has frequently resulted in an unacceptable delay in diagnosis and treatment, sometimes with grave consequences. A high index of suspicion coupled with early diagnosis may reduce or even prevent the serious long-term complications of these diseases. In this paper, we review the epidemiology, clinical features, diagnosis, treatment and outcome of patients with APRT deficiency, cystinuria, Dent disease, FHHNC and PH with emphasis on childhood manifestations. PMID:23334384

  18. Adult stem-like cells in kidney.

    PubMed

    Hishikawa, Keiichi; Takase, Osamu; Yoshikawa, Masahiro; Tsujimura, Taro; Nangaku, Masaomi; Takato, Tsuyoshi

    2015-03-26

    Human pluripotent cells are promising for treatment for kidney diseases, but the protocols for derivation of kidney cell types are still controversial. Kidney tissue regeneration is well confirmed in several lower vertebrates such as fish, and the repair of nephrons after tubular damages is commonly observed after renal injury. Even in adult mammal kidney, renal progenitor cell or system is reportedly presents suggesting that adult stem-like cells in kidney can be practical clinical targets for kidney diseases. However, it is still unclear if kidney stem cells or stem-like cells exist or not. In general, stemness is defined by several factors such as self-renewal capacity, multi-lineage potency and characteristic gene expression profiles. The definite use of stemness may be obstacle to understand kidney regeneration, and here we describe the recent broad findings of kidney regeneration and the cells that contribute regeneration. PMID:25815133

  19. Current Bioengineering Methods for Whole Kidney Regeneration

    PubMed Central

    Yamanaka, Shuichiro; Yokoo, Takashi

    2015-01-01

    Kidney regeneration is likely to provide an inexhaustible source of tissues and organs for immunosuppression-free transplantation. It is currently garnering considerable attention and might replace kidney dialysis as the ultimate therapeutic strategy for renal failure. However, anatomical complications make kidney regeneration difficult. Here, we review recent advances in the field of kidney regeneration, including (i) the directed differentiation of induced pluripotent stem cells/embryonic stem cells into kidney cells; (ii) blastocyst decomplementation; (iii) use of a decellularized cadaveric scaffold; (iv) embryonic organ transplantation; and (v) use of a nephrogenic niche for growing xenoembryos for de novo kidney regeneration from stem cells. All these approaches represent potentially promising therapeutic strategies for the treatment of patients with chronic kidney disease. Although many obstacles to kidney regeneration remain, we hope that innovative strategies and reliable research will ultimately allow the restoration of renal function in patients with end-stage kidney disease. PMID:26089921

  20. Quantitative autoradiography of angiotensin II receptors in brain and kidney: focus on cardiovascular implications

    SciTech Connect

    Gehlert, D.R.; Speth, R.C.; Wamsley, J.K.

    1985-01-01

    Quantitative techniques of receptor autoradiography have been applied to localize (/sup 125/I)-angiotensin II binding sites in brain and kidney. High densities of autoradiographic grains, indicating the presence of angiotensin II receptors, have been localized to several rat brain nuclei including the dorsal motor nucleus of the vagus, nucleus of the solitary tract, anterior pituitary, locus coeruleus and several hypothalamic nuclei. Cat thoracic spinal cord exhibited a high density of sites over the intermedio-lateral cell column. In sections of rat kidney, angiotensin II receptors were detected in the glomerulus, vasa recta and ureter. The cardiovascular implications of these results are apparent and relate angiotensin II to hypertensive mechanisms. Thus, angiotensin II represents an endocoid which is involved in control of blood pressure through its effects on peripheral organs as well as the central nervous system.

  1. Living kidney donors and ESRD.

    PubMed

    Ross, Lainie Friedman

    2015-07-01

    There are more than 325 living kidney donors who have developed end-stage renal disease and have been listed on the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) deceased donor kidney wait list. The OPTN/UNOS database records where these kidney donors are listed and, if they donated after April 1994, where that donation occurred. These 2 locations are often not the same. In this commentary, I examine whether a national living donor registry should be created and whether transplantation centers should be notified when one of their living kidney donors develops end-stage renal disease. I consider and refute 5 potential objections to center notification. I explain that transplantation centers should look back at these cases and input data into a registry to attempt to identify patterns that could improve donor evaluation protocols. Creating a registry and mining the information it contains is, in my view, our moral and professional responsibility to future patients and the transplantation endeavor. As individuals and as a community, we need to acknowledge the many unknown risks of living kidney donation and take responsibility for identifying these risks. We then must share information about these risks, educate prospective donors about them, and attempt to minimize them. PMID:25936672

  2. Multidetector CT of the kidney.

    PubMed

    Coppenrath, E M; Mueller-Lisse, U G

    2006-11-01

    The technological development of multidetector CT offers new possibilities for better imaging of organic structures that can be used in diagnosis of the kidney. The thinner slices allow a better spatial resolution, and slice fusion allows improved contrast resolution. The isotropic voxel has been realized in the latest 64-channel scanners. The image quality of arbitrarily reconstructed planes has arrived at the image quality of the scan plane. Faster scanning allows studies in different contrast phases, which is helpful for better discrimination of benign or malignant lesions especially in the highly vascularized kidney. Different phases of contrast uptake can be differentiated (arterial, cortico-medullary, nephrographic, and excretory phase). Multidetector CT brings along the risk of increased dose due to thinner slice collimation and overranging phenomena. Indications for CT investigation of the kidney include urolithiasis, tumor diagnosis and staging, renal trauma, and vascular disease. Even in children, special indications for CT of the kidney remain in polytrauma and tumor staging. Multidetector CT of the kidney has become a very valuable tool in urology, but a careful protocol strategy is mandatory. PMID:16568265

  3. Gene therapy approaches for spinal cord injury

    NASA Astrophysics Data System (ADS)

    Bright, Corinne

    As the biomedical engineering field expands, combination technologies are demonstrating enormous potential for treating human disease. In particular, intersections between the rapidly developing fields of gene therapy and tissue engineering hold promise to achieve tissue regeneration. Nonviral gene therapy uses plasmid DNA to deliver therapeutic proteins in vivo for extended periods of time. Tissue engineering employs biomedical materials, such as polymers, to support the regrowth of injured tissue. In this thesis, a combination strategy to deliver genes and drugs in a polymeric scaffold was applied to a spinal cord injury model. In order to develop a platform technology to treat spinal cord injury, several nonviral gene delivery systems and polymeric scaffolds were evaluated in vitro and in vivo. Nonviral vector trafficking was evaluated in primary neuronal culture to develop an understanding of the barriers to gene transfer in neurons and their supporting glia. Although the most efficient gene carrier in vitro differed from the optimal gene carrier in vivo, confocal and electron microscopy of these nonviral vectors provided insights into the interaction of these vectors with the nucleus. A novel pathway for delivering nanoparticles into the nuclei of neurons and Schwann cells via vesicle trafficking was observed in this study. Reporter gene expression levels were evaluated after direct and remote delivery to the spinal cord, and the optimal nonviral vector, dose, and delivery strategy were applied to deliver the gene encoding the basic fibroblast growth factor (bFGF) to the spinal cord. An injectable and biocompatible gel, composed of the amphiphillic polymer poly(ethylene glycol)-poly(epsilon-caprolactone)-poly(ethylene glycol) (PEG-PCL-PEG) was evaluated as a drug and gene delivery system in vitro, and combined with the optimized nonviral gene delivery system to treat spinal cord injury. Plasmid DNA encoding the bFGF gene and the therapeutic NEP1--40 peptide were incorporated in the PEG-PCL-PEG gel and injected into a lesion transecting the main dorsomedial and minor ventral medial corticospinal tract (CST). The degree of collateralization of the transected CST was quantified as an indicator of the regenerative potential of these treatments. At one month post-injury, we observed the robust rostral collateralization of the CST tract in response to the bFGF plasmid-loaded gel. In conclusion, we hope that this platform technology can be applied to the sustained local delivery of other proteins for the treatment of spinal cord injury.

  4. Supernumerary Kidney With a Horseshoe Component☆

    PubMed Central

    Fathollahi, Ali

    2014-01-01

    We report a case of supernumerary kidney consisting of 4 renal moieties and including a horseshoe kidney. A 40-year-old woman presented complaining of intermittent vague abdominal pain and heaviness for a few years. Ultrasonography of the urinary tract revealed 2 kidneys on the left side and horseshoe kidneys located distal to them. The right horseshoe kidney was of small size. Further imaging revealed 4 renal moieties. Three moieties were on the left side and the other was attached to the most distal moiety on the left, forming a horseshoe kidney.

  5. Umbilical cord blood transplant for malignancies: a hope or hype.

    PubMed

    Bahl, Ankur; Bakhshi, Sameer

    2013-08-01

    Cord blood is a rich and unlimited source of hematopoietic stem cells for allogeneic stem cell transplant to treat a variety of oncologic, genetic, hematologic, and immunodeficiency disorders. Since the first successful cord blood transplant in 1988, a large number of cord blood banks have been established world over for collection and storage of cord blood for future use. Majority of such transplants are performed in children, however, the number in adults have been growing steadily in recent years. Results from various transplant registries reveals that a single cord blood provides enough stem cells to provide short and long term engraftment, and has low incidence and less severity of graft versus host disease. With a high booming birth rate and a large genetic diversity, India has potential to become the largest supplier of cord blood stem cells in world. To meet the future transplant need of the country sincere efforts from various institutes and government agencies are needed to increase the number of public cord blood banks in the country. In this article the author will focus on the issue of public and private cord blood banking; the role of physicians in educating and counseling families with regard to the utility of cord blood for donor itself as well as the future of umbilical cord blood transplant in India. PMID:23660949

  6. Knowledge about umbilical cord blood banking among Greek citizens

    PubMed Central

    Karagiorgou, Louiza Z.; Pantazopoulou, Maria-Nikoletta P.; Mainas, Nikolaos C.; Beloukas, Apostolos I.; Kriebardis, Anastasios G.

    2014-01-01

    Background Umbilical cord blood supplies in Greece are not sufficient to meet the high transfusion needs. This study was designed to determine Greeks’ opinion about umbilical cord blood, identify the reasons for the lack of motivation to donate umbilical cord blood and allow experts to establish better recruitment campaigns to enrich the donor pool. Materials and methods The attitudes and knowledge about umbilical cord blood of randomly selected Greek citizens (n=1,019) were assessed by means of a standardised anonymous questionnaire. The results were analysed using the χ2test and Spearman’s correlation coefficient. Results Forty-eight percent of respondents knew about umbilical cord blood and had full knowledge about what storage/donation offers. Media (35%) and doctors (25%) were the main source of information. The information from the state was considered either inadequate or non-existent by 85% of the responders. Ninety-five percent of the people questioned would like further information regarding umbilical cord blood transplantation and umbilical cord blood storage/donation. Six percent of the respondents who had children and were in favour of umbilical cord blood transplantation, had stored/donated UCB. With regards to future decisions, 84% of the sample would store/donate umbilical cord blood, of whom 57% would keep the umbilical cord blood in a private bank. Discussion It was concluded that Greek citizens receive information about umbilical cord blood from both the state and advertising campaigns by the Ministry of Health and Social Solidarity. A kind of cooperation between all hospitals and public umbilical cord blood banks would be advisable in order to facilitate access to umbilical cord blood donations. PMID:24120604

  7. Computational analysis of kidney scintigrams

    SciTech Connect

    Vrincianu, D.; Puscasu, E.; Creanga, D.; Stefanescu, C.

    2013-11-13

    The scintigraphic investigation of normal and pathological kidneys was carried out using specialized gamma-camera device from nuclear medicine hospital department. Technetium 90m isotope with gamma radiation emission, coupled with vector molecules for kidney tissues was introduced into the subject body, its dynamics being recorded as data source for kidney clearance capacity. Two representative data series were investigated, corresponding to healthy and pathological organs respectively. The semi-quantitative tests applied for the comparison of the two distinct medical situations were: the shape of probability distribution histogram, the power spectrum, the auto-correlation function and the Lyapunov exponent. While power spectrum led to similar results in both cases, significant differences were revealed by means of distribution probability, Lyapunov exponent and correlation time, recommending these numerical tests as possible complementary tools in clinical diagnosis.

  8. Radiation-associated kidney injury.

    PubMed

    Dawson, Laura A; Kavanagh, Brian D; Paulino, Arnold C; Das, Shiva K; Miften, Moyed; Li, X Allen; Pan, Charlie; Ten Haken, Randall K; Schultheiss, Timothy E

    2010-03-01

    The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation. The incidence of radiotherapy-associated kidney injury is likely underreported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury. The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over years. A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. The available predictive models are suboptimal and require validation. Mitigation of radiation nephropathy with angiotensin-converting enzyme inhibitors and other compounds has been shown in animal models and, more recently, in patients. PMID:20171504

  9. Radiation-Associated Kidney Injury

    SciTech Connect

    Dawson, Laura A.; Kavanagh, Brian D.; Paulino, Arnold C.; Das, Shiva K.; Miften, Moyed; Li, X. Allen; Pan, Charlie; Ten Haken, Randall K.; Schultheiss, Timothy E.

    2010-03-01

    The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation. The incidence of radiotherapy-associated kidney injury is likely underreported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury. The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over years. A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. The available predictive models are suboptimal and require validation. Mitigation of radiation nephropathy with angiotensin-converting enzyme inhibitors and other compounds has been shown in animal models and, more recently, in patients.

  10. Growing kidney in the frog.

    PubMed

    Chan, Techuan; Asashima, Makoto

    2006-01-01

    An understanding of the regulation of kidney development has increased dramatically in the past decade. The pronephros, mesonephros, and metanephros represent three distinct renal organs that function, in succession, as the vertebrate excretory system during development of the kidney. These three organ systems are derived from the intermediate mesoderm and develop in a well-defined temporal and spatial sequence. The pronephros, which consists of a tubule, duct and glomus, is established first and is the simplest of the excretory organs in vertebrates. Xenopus pronephros serves as an ideal model for investigating organogenesis and development of renal function in vertebrates. In this article, we highlight the advantages of Xenopus for analyzing kidney organogenesis and the latest research in pronephros development. PMID:16554664

  11. The exposome for kidney stones.

    PubMed

    Goldfarb, David S

    2016-02-01

    The exposome is the assembly and measure of all the exposures of an individual in a lifetime. An individual's exposures begin before birth and include insults from environmental and occupational sources. The associated field is called exposomics, which relies on the application of internal and external exposure assessment methods. Exposomics has not yet been thoroughly applied to the study of kidney stones although much is known about how diet and fluid intake affect nephrolithiasis. Some other novel exposures that may contribute to kidney stones are discussed including use of antibiotics, urbanization and migration to urban heat islands, and occupation. People whose school and jobs limit their access to fluids and adequate bathroom facilities may have higher prevalence of stones. Examples include athletes, teachers, heathcare workers, and cab drivers. Occupational kidney stones have received scant attention and may represent a neglected, and preventable, type of stone. An exposomic-oriented history would include a careful delineation of occupation and activities. PMID:26615595

  12. Computational analysis of kidney scintigrams

    NASA Astrophysics Data System (ADS)

    Vrincianu, D.; Puscasu, E.; Creanga, D.; Stefanescu, C.

    2013-11-01

    The scintigraphic investigation of normal and pathological kidneys was carried out using specialized gamma-camera device from nuclear medicine hospital department. Technetium 90m isotope with gamma radiation emission, coupled with vector molecules for kidney tissues was introduced into the subject body, its dynamics being recorded as data source for kidney clearance capacity. Two representative data series were investigated, corresponding to healthy and pathological organs respectively. The semi-quantitative tests applied for the comparison of the two distinct medical situations were: the shape of probability distribution histogram, the power spectrum, the auto-correlation function and the Lyapunov exponent. While power spectrum led to similar results in both cases, significant differences were revealed by means of distribution probability, Lyapunov exponent and correlation time, recommending these numerical tests as possible complementary tools in clinical diagnosis.

  13. Relationship between Spinal Cord Volume and Spinal Cord Injury due to Spinal Shortening

    PubMed Central

    Qiu, Feng; Yang, Jin-Cheng; Ma, Xiang-Yang; Xu, Jun-Jie; Yang, Qing-Lei; Zhou, Xin; Xiao, Yao-Sheng; Hu, Hai-Sheng; Xia, Li-Hui

    2015-01-01

    Vertebral column resection is associated with a risk of spinal cord injury. In the present study, using a goat model, we aimed to investigate the relationship between changes in spinal cord volume and spinal cord injury due to spinal shortening, and to quantify the spinal cord volume per 1-mm height in order to clarify a safe limit for shortening. Vertebral column resection was performed at T10 in 10 goats. The spinal cord was shortened until the somatosensory-evoked potential was decreased by 50% from the baseline amplitude or delayed by 10% relative to the baseline peak latency. A wake-up test was performed, and the goats were observed for two days postoperatively. Magnetic resonance imaging was used to measure the spinal cord volume, T10 height, disc height, osteotomy segment height, and spinal segment height pre- and postoperatively. Two of the 10 goats were excluded, and hence, only data from eight goats were analyzed. The somatosensory-evoked potential of these eight goats demonstrated meaningful changes. With regard to neurologic function, five and three goats were classified as Tarlov grades 5 and 4 at two days postoperatively. The mean shortening distance was 23.6 ± 1.51 mm, which correlated with the d-value (post-pre) of the spinal cord volume per 1-mm height of the osteotomy segment (r = 0.95, p < 0.001) and with the height of the T10 body (r = 0.79, p = 0.02). The mean d-value (post-pre) of the spinal cord volume per 1-mm height of the osteotomy segment was 142.87 ± 0.59 mm3 (range, 142.19–143.67 mm3). The limit for shortening was approximately 106% of the vertebral height. The mean volumes of the osteotomy and spinal segments did not significantly change after surgery (t = 0.310, p = 0.765 and t = 1.241, p = 0.255, respectively). Thus, our results indicate that the safe limit for shortening can be calculated using the change in spinal cord volume per 1-mm height. PMID:26001196

  14. Mathematical Modeling of Kidney Transport

    PubMed Central

    Layton, Anita T.

    2013-01-01

    In addition to metabolic waste and toxin excretion, the kidney also plays an indispensable role in regulating the balance of water, electrolytes, nitrogen, and acid-base. In this review, we describe representative mathematical models that have been developed to better understand kidney physiology and pathophysiology, including the regulation of glomerular filtration, the regulation of renal blood flow by means of the tubuloglomerular feedback mechanisms and of the myogenic mechanism, the urine concentrating mechanism, epithelial transport, and regulation of renal oxygen transport. We discuss the extent to which these modeling efforts have expanded our understanding of renal function in both health and disease. PMID:23852667

  15. Current trends in spinal cord injury repair.

    PubMed

    Yu, W-Y; He, D-W

    2015-09-01

    One of the rapidly prevailing neurological disorders affecting thousands of people per year is spinal cord injury (SCI). Though, great research has been made in recent past to understand thoroughly the molecular bases of the diseases, no fully restorative treatments for SCI are available. However, various rehabilitative, cellular and molecular therapies are being tested in animal models. Some of them have shown promising results. So, the present review shall enlighten all these latest developments in the field of spinal cord injury repair. The review shall discuss latest upcoming areas being focused for the management of SCI patients like stem cell therapy approach, cell-based approaches, combination therapeutic approaches, neuronal plasticity and possible use of omega-3 fatty acids in SCI repair. PMID:26439026

  16. Hydrogels in Spinal Cord Injury Repair Strategies

    PubMed Central

    2011-01-01

    Nowadays there are at present no efficient therapies for spinal cord injury (SCI), and new approaches have to be proposed. Recently, a new regenerative medicine strategy has been suggested using smart biomaterials able to carry and deliver cells and/or drugs in the damaged spinal cord. Among the wide field of emerging materials, research has been focused on hydrogels, three-dimensional polymeric networks able to swell and absorb a large amount of water. The present paper intends to give an overview of a wide range of natural, synthetic, and composite hydrogels with particular efforts for the ones studied in the last five years. Here, different hydrogel applications are underlined, together with their different nature, in order to have a clearer view of what is happening in one of the most sparkling fields of regenerative medicine. PMID:22816020

  17. Hydrogels in spinal cord injury repair strategies.

    PubMed

    Perale, Giuseppe; Rossi, Filippo; Sundstrom, Erik; Bacchiega, Sara; Masi, Maurizio; Forloni, Gianluigi; Veglianese, Pietro

    2011-07-20

    Nowadays there are at present no efficient therapies for spinal cord injury (SCI), and new approaches have to be proposed. Recently, a new regenerative medicine strategy has been suggested using smart biomaterials able to carry and deliver cells and/or drugs in the damaged spinal cord. Among the wide field of emerging materials, research has been focused on hydrogels, three-dimensional polymeric networks able to swell and absorb a large amount of water. The present paper intends to give an overview of a wide range of natural, synthetic, and composite hydrogels with particular efforts for the ones studied in the last five years. Here, different hydrogel applications are underlined, together with their different nature, in order to have a clearer view of what is happening in one of the most sparkling fields of regenerative medicine. PMID:22816020

  18. Bowel Management in Spinal Cord Injury Patients

    PubMed Central

    Hughes, Matthew

    2014-01-01

    Spinal cord injuries are common in the United States, affecting approximately 12,000 people per year. Most of these patients lack normal bowel function. The pattern of dysfunction varies with the spinal level involved. Most patients use a bowel management program, and elements of successful programs are discussed. Surgical treatment, when indicated, could include sacral nerve stimulation, Malone antegrade continence enema, and colostomy. PMID:25320571

  19. Cadmium content of umbilical cord blood.

    PubMed

    Rabinowitz, M; Finch, H

    1984-06-01

    Cadmium was measured in the umbilical cord blood at birth from 94 healthy babies. Samples were dried and ashed at low temperatures with an oxygen plasma prior to atomic absorption spectrometry. The concentration of cadmium ranged from 0.003 to 0.210 microgram/dl, with a mean of 0.045 +/- 0.063 (SD). Blood lead, maternal smoking, and proximity of residence to automobile traffic were not statistically related to cadmium levels. PMID:6723601

  20. Cadmium content of umbilical cord blood

    SciTech Connect

    Rabinowitz, M.; Finch, H.

    1984-06-01

    Cadmium was measured in the umbilical cord blood at birth from 94 healthy babies. Samples were dried and ashed at low temperatures with an oxygen plasma prior to atomic absorption spectrometry. The concentration of cadmium ranged from 0.003 to 0.210 ..mu..g/dl, with a mean of 0.045 +/- 0.063 (SD). Blood lead, maternal smoking, and proximity of residence to automobile traffic were not statistically related to cadmium levels.

  1. Spinal cord dysfunction from lumbar disk herniation.

    PubMed

    Pau, A; Cossu, M; Turtas, S; Zirattu, G

    1989-12-01

    Two patients with a herniated disk respectively at the level of the L4-L5 and of the L5-S1 intervertebral spaces presented with pyramidal signs, bladder paralysis and radicular impairment. The symptoms subsided immediately following surgical removal of the prolapsed disk. The role of transient ischemia in the lower segments of the spinal cord as possible cause of this uncommon clinical picture is discussed, and the pertinent literature is reviewed. PMID:2618830

  2. Tracking Changes following Spinal Cord Injury

    PubMed Central

    Curt, Armin; Friston, Karl; Thompson, Alan

    2013-01-01

    Traumatic spinal cord injury is often disabling and recovery of function is limited. As a consequence of damage, both spinal cord and brain undergo anatomical and functional changes. Besides clinical measures of recovery, biomarkers that can detect early anatomical and functional changes might be useful in determining clinical outcomeduring the course of rehabilitation and recoveryas well as furnishing a tool to evaluate novel treatment interventions and their mechanisms of action. Recent evidence suggests an interesting three-way relationship between neurological deficit and changes in the spinal cord and of the brain and that, importantly, noninvasive magnetic resonance imaging techniques, both structural and functional, provide a sensitive tool to lay out these interactions. This review describes recent findings from multimodal imaging studies of remote anatomical changes (i.e., beyond the lesion site), cortical reorganization, and their relationship to clinical disability. These developments in this field may improve our understanding of effects on the nervous system that are attributable to the injury itself and will allow their distinction from changes that result from rehabilitation (i.e., functional retraining) and from interventions affecting the nervous system directly (i.e., neuroprotection or regeneration). PMID:22730072

  3. Nanofibrous Patches for Spinal Cord Regeneration.

    PubMed

    Zhu, Yiqian; Wang, Aijun; Shen, Wenqian; Patel, Shyam; Zhang, Rong; Young, William; Li, Song

    2010-05-10

    The difficulty in spinal cord regeneration is related to the inhibitory factors for axon growth and the lack of appropriate axon guidance in the lesion region. Here we developed scaffolds with aligned nanofibers for nerve guidance and drug delivery in spinal cord. Blended polymers including Poly (l-lactic acid) (PLLA) and Poly (lactide-co-glycolide) (PLGA) were used to electrospin nanofibrous scaffolds with two-layer structure: aligned nanofibers in the inner layer and random nanofibers in the outer layer. Rolipram, a small molecule that can enhance cAMP activity in neurons and suppress inflammatory responses, was immobilized onto nanofibers. To test the therapeutic effects of nanofibrous scaffolds, the nanofibrous scaffolds loaded with rolipram were used to bridge the hemisection lesion in 8-week old athymic rats. The scaffolds with rolipram increased axon growth through the scaffolds and in the lesion, promoted angiogenesis through the scaffold, and decreased the population of astrocytes and chondroitin sulfate proteoglycans in the lesion. Locomotor scale rating analysis showed that the scaffolds with rolipram significantly improved hindlimb function after 3 weeks. This study demonstrated that nanofibrous scaffolds offered a valuable platform for drug delivery for spinal cord regeneration. PMID:23378825

  4. Serotonergic transmission after spinal cord injury.

    PubMed

    Nardone, Raffaele; Hller, Yvonne; Thomschewski, Aljoscha; Hller, Peter; Lochner, Piergiorgio; Golaszewski, Stefan; Brigo, Francesco; Trinka, Eugen

    2015-02-01

    Changes in descending serotonergic innervation of spinal neural activity have been implicated in symptoms of paralysis, spasticity, sensory disturbances and pain following spinal cord injury (SCI). Serotonergic neurons possess an enhanced ability to regenerate or sprout after many types of injury, including SCI. Current research suggests that serotonine (5-HT) release within the ventral horn of the spinal cord plays a critical role in motor function, and activation of 5-HT receptors mediates locomotor control. 5-HT originating from the brain stem inhibits sensory afferent transmission and associated spinal reflexes; by abolishing 5-HT innervation SCI leads to a disinhibition of sensory transmission. 5-HT denervation supersensitivity is one of the key mechanisms underlying the increased motoneuron excitability that occurs after SCI, and this hyperexcitability has been demonstrated to underlie the pathogenesis of spasticity after SCI. Moreover, emerging evidence implicates serotonergic descending facilitatory pathways from the brainstem to the spinal cord in the maintenance of pathologic pain. There are functional relevant connections between the descending serotonergic system from the rostral ventromedial medulla in the brainstem, the 5-HT receptors in the spinal dorsal horn, and the descending pain facilitation after tissue and nerve injury. This narrative review focussed on the most important studies that have investigated the above-mentioned effects of impaired 5-HT-transmission in humans after SCI. We also briefly discussed the promising therapeutical approaches with serotonergic drugs, monoclonal antibodies and intraspinal cell transplantation. PMID:24866695

  5. Recent therapeutic approaches for spinal cord injury.

    PubMed

    Raspa, Andrea; Pugliese, Raffaele; Maleki, Mahboubeh; Gelain, Fabrizio

    2016-02-01

    A spinal cord injury (SCI) often causes permanent changes in strength and sensation functions below the site of the injury and affects thousands of people each year. Transplantation of stem cells is a promising approach in acute SCI as it may support spinal cord repair. However, in case of chronic SCI greater amounts of nervous tissue have to be regenerated, leaving scaffold transplantation the only feasible option for cellular engraftment and nervous bridging. The aim of regenerative medicine, specifically tissue engineering, is to create a microenvironment that mimics native extracellular matrix (ECM), capable of promoting specific cell-matrix interactions, coaxing cell behavior, and fostering host tissue regeneration. In this regard, nanostructured scaffolds are currently the most promising advanced substrates capable of supporting nervous fiber ingrowth and delivery of neurotrophic drugs. Among them, electrospinning technique and Self-Assembling Peptides (SAPs) have recently attracted lots of attention for their reproducible synthesis and high tailorability. This review highlights clinical trials and recent encouraging strategies for spinal cord repair comprising both cell therapy and nanomedicine. Biotechnol. Bioeng. 2016;113: 253-259. © 2015 Wiley Periodicals, Inc. PMID:26134352

  6. Funic reduction for the management of umbilical cord prolapse.

    PubMed

    Barrett, J M

    1991-09-01

    The current management of umbilical cord prolapse centers on attempts to alleviate the pressure of the presenting part on the cord while preparation for cesarean section is being made. A 10-year experience in which there were vigorous attempts to accomplish safe vaginal delivery after the diagnosis of umbilical cord prolapse is presented. Eight cases of umbilical cord prolapse occurred, a frequency of 1 in 277 deliveries (0.37%), all of which had a normal immediate neonatal outcome. Vaginal delivery was accomplished in seven patients (87.5%); diagnosis was made in two of them when delivery was imminent. Five patients were more remote from delivery and had successful funic reduction (manual replacement of the prolapsed cord). Funic reduction is proposed as a potentially beneficial initial step in the management of umbilical cord prolapse. PMID:1892193

  7. Private cord blood banking: current use and clinical future.

    PubMed

    Hollands, Peter; McCauley, Catherina

    2009-09-01

    International private umbilical cord blood banking has expanded rapidly in recent years since the first cord blood transplant which was 20 years ago. Private companies offer parents the opportunity to store umbilical cord blood for the possible future use by their child or other family members. The private cord blood industry has been criticised by a number of professional bodies including the EU Ethics Committee, the Royal College of Obstetrics and Gynaecology, the Royal College of Midwives and the US College of Paediatrics. This review presents the arguments from the opponents of private cord blood banking, and then makes the case for private cord banking based on the latest scientific and clinical evidence. PMID:19603288

  8. Kidney Stones in Children and Teens

    MedlinePLUS

    ... Email Print Share Kidney Stones in Children and Teens Page Content Article Body ​Kidney stones are hard ... age, even in premature infants , most occur in teens , with teen girls having the highest incidence. Types ...

  9. Heartburn Meds Linked to Chronic Kidney Disease

    MedlinePLUS

    ... gov/medlineplus/news/fullstory_156632.html Heartburn Meds Linked to Chronic Kidney Disease While study can't ... heartburn medication called proton pump inhibitors may be linked to long-term kidney damage, a new study ...

  10. Prevent Diabetes Problems: Keep Your Kidneys Healthy

    MedlinePLUS

    ... Fund National Kidney Foundation American Diabetes Association JDRF Diabetes Disease Organizations Many organizations provide support to patients ... PDF, 293 KB). Alternate Language URL Español Prevent diabetes problems: Keep your kidneys healthy Page Content On ...

  11. Biologic Therapy (Immunotherapy) for Kidney Cancer

    MedlinePLUS

    ... Next Topic Chemotherapy for kidney cancer Biologic therapy (immunotherapy) for kidney cancer The goal of biologic therapy ... to suppress your immune system. Newer approaches to immunotherapy Cytokines can also be used as part of ...

  12. Opdivo Approved for Advanced Kidney Cancer

    MedlinePLUS

    ... news/fullstory_155894.html Opdivo Approved for Advanced Kidney Cancer More than 14,000 projected to die ... renal cell carcinoma, the most common type of kidney cancer. The drug targets proteins that would otherwise ...

  13. Autophagy in Kidney Health and Disease

    PubMed Central

    Wang, Zhibo

    2014-01-01

    Abstract Significance: Autophagy is emerging as an important pathway in many biological processes and diseases. This review summarizes the current progress on the role of autophagy in renal physiology and pathology. Recent Advances: Studies from renal cells in culture, human kidney tissues, and experimental animal models implicate that autophagy regulates many critical aspects of normal and disease conditions in the kidney, such as diabetic nephropathy and other glomerular diseases, tubular injuries, kidney development and aging, cancer, and genetic diseases associated with the kidney. Critical Issues: The importance of autophagy in the kidney has just started to be elucidated. How the process of autophagy is altered in the pathogenesis of kidney diseases and how this alteration is beneficial or detrimental to kidney functions still need to be fully understood. Future Directions: Investigations that uncover the precise mechanism and regulation of autophagy in various kidney diseases may lead to new strategies for therapeutic modulation. Antioxid. Redox Signal. 20, 519537. PMID:23642034

  14. Kidney Transplant 'Tourism' Comes with Risks

    MedlinePLUS

    ... nlm.nih.gov/medlineplus/news/fullstory_155565.html Kidney Transplant 'Tourism' Comes With Risks: Study Infections, complications, ... people languish on a wait-list for a kidney transplant, they may start to consider a desperate ...

  15. Treatment Methods for Kidney Failure: Peritoneal Dialysis

    MedlinePLUS

    ... Share External Link Disclaimer Kidney Disease Peritoneal Dialysis Alternate Versions ​ Treatment Methods for Kidney Failure: Peritoneal Dialysis ( ... or in your home life. Accepting this new reality can be very hard on you and your ...

  16. Multimodal Approach to the Management of Metastatic Epidural Spinal Cord Compression (MESCC) Due to Solid Tumors

    SciTech Connect

    Tancioni, Flavio; Navarria, Pierina; Lorenzetti, Martin A.; Pedrazzoli, Paolo; Masci, Giovanna; Mancosu, Pietro; Alloisio, Marco; Morenghi, Emanuela; Santoro, Armando; Rodriguez y Baena, Riccardo; Scorsetti, Marta

    2010-12-01

    Purpose: To assess the impact of a multidisciplinary approach for treatment of patients with metastatic epidural spinal cord compression in terms of feasibility, local control, and survival. Methods and Materials: Eighty-nine consecutive patients treated between January 2004 and December 2007 were included. The most common primary cancers were lung, breast, and kidney cancers. Ninety-eight surgical procedures were performed. Radiotherapy was performed within the first month postoperatively. Clinical outcome was evaluated by modified visual analog scale for pain, Frankel scale for neurologic deficit, and magnetic resonance imaging or computed tomography scan. Nearly all patients (93%) had back pain before treatment, whereas major or minor preoperative neurologic deficit was present in 62 cases (63%). Results: Clinical remission of pain was obtained in the vast majority of patients (91%). Improvement of neurologic deficit was observed in 45 cases (72.5%). Local relapse occurred in 10%. Median survival was 11 months (range, 0-46 months). Overall survival at 1 year was 43.6%. Type of primary tumor significantly affected survival. Conclusions: In patients with metastatic epidural spinal cord compression, the combination of surgery plus radiotherapy is feasible and provides clinical benefit in most patients. The discussion of each single case within a multidisciplinary team has been of pivotal importance in implementing the most appropriate therapeutic approach.

  17. Biodistribution of Infused Human Umbilical Cord Blood Cells in Alzheimer's Disease-Like Murine Model.

    PubMed

    Ehrhart, Jared; Darlington, Donna; Kuzmin-Nichols, Nicole; Sanberg, Cyndy D; Sawmiller, Darrell R; Sanberg, Paul R; Tan, Jun

    2016-01-01

    Human umbilical cord blood cells (HUCBCs), a prolific source of non-embryonic or adult stem cells, have emerged as effective and relatively safe immunomodulators and neuroprotectors, reducing behavioral impairment in animal models of Alzheimer's disease (AD), Parkinson's disease, amyotrophic lateral sclerosis, traumatic brain injury, spinal cord injury, and stroke. In this report, we followed the bioavailability of HUCBCs in AD-like transgenic PSAPP mice and nontransgenic Sprague-Dawley rats. HUCBCs were injected into tail veins of mice or rats at a single dose of 1??10(6) or 2.2??10(6) cells, respectively, prior to harvesting of tissues at 24 h, 7 days, and 30 days after injection. For determination of HUCBC distribution, tissues from both species were subjected to total DNA isolation and polymerase chain reaction (PCR) amplification of the gene for human glycerol-3-phosphate dehydrogenase. Our results show a relatively similar biodistribution and retention of HUCBCs in both mouse and rat organs. HUCBCs were broadly detected both in the brain and several peripheral organs, including the liver, kidney, and bone marrow, of both species, starting within 7 days and continuing up to 30 days posttransplantation. No HUCBCs were recovered in the peripheral circulation, even at 24 h posttransplantation. Therefore, HUCBCs reach several tissues including the brain following a single intravenous treatment, suggesting that this route can be a viable method of administration of these cells for the treatment of neurodegenerative diseases. PMID:26414627

  18. What I Need to Know about Living with Kidney Failure

    MedlinePLUS

    ... American Kidney Fund Life Options National Kidney Foundation Kidney and Urologic Disease Organizations Many organizations provide support ... What I need to know about Living with Kidney Failure Page Content On this page: What is ...

  19. Detecting Kidney and Urinary Tract Abnormalities Before Birth

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  20. Treatment Option Overview (Wilms Tumor and Other Childhood Kidney Tumors)

    MedlinePLUS

    ... Kidney Cancer Research Wilms Tumor and Other Childhood Kidney Tumors Treatment–Patient Version (PDQ®) General Information About Wilms Tumor and Other Childhood Kidney Tumors Key Points Childhood kidney tumors are diseases ...

  1. Metabolic Syndrome after Kidney Transplantation - Are You at Risk?

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  2. General Information about Wilms Tumor and Other Childhood Kidney Tumors

    MedlinePLUS

    ... Kidney Cancer Research Wilms Tumor and Other Childhood Kidney Tumors Treatment–Patient Version (PDQ®) General Information About Wilms Tumor and Other Childhood Kidney Tumors Key Points Childhood kidney tumors are diseases ...

  3. Use of Herbal Supplements in Chronic Kidney Disease

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  4. Children with Chronic Kidney Disease: Tips for Parents

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  5. Do You Have Symptoms of a Kidney Stone?

    MedlinePLUS

    ... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... Health checks Your Kidneys and You Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

  6. Genetics Home Reference: REN-related kidney disease

    MedlinePLUS

    ... kidneys become less able to filter fluids and waste products from the body, resulting in kidney failure. ... related kidney disease typically require dialysis (to remove wastes from the blood) or a kidney transplant between ...

  7. Cellular therapies for treating pain associated with spinal cord injury

    PubMed Central

    2012-01-01

    Spinal cord injury leads to immense disability and loss of quality of life in human with no satisfactory clinical cure. Cell-based or cell-related therapies have emerged as promising therapeutic potentials both in regeneration of spinal cord and mitigation of neuropathic pain due to spinal cord injury. This article reviews the various options and their latest developments with an update on their therapeutic potentials and clinical trialing. PMID:22394650

  8. Vocal Cord Paralysis and its Etiologies: A Prospective Study

    PubMed Central

    Seyed Toutounchi, Seyed Javad; Eydi, Mahmood; Golzari, Samad EJ; Ghaffari, Mohammad Reza; Parvizian, Nashmil

    2014-01-01

    Introduction: Vocal cord paralysis is a common symptom of numerous diseases and it may be due to neurogenic or mechanical fixation of the cords. Paralysis of the vocal cords is just a symptom of underlying disease in some cases; so, clinical diagnosis of the underlying cause leading to paralysis of the vocal cords is important. This study evaluates the causes of vocal cord paralysis. Methods: In a prospective study, 45 patients with paralyzed vocal cord diagnosis were examined by tests such as examination of the pharynx, larynx, esophagus, thyroid, cervical, lung, and mediastinum, brain and heart by diagnostic imaging to investigate the cause vocal cord paralysis. The study was ended by diagnosing the reason of vocal cord paralysis at each stage of the examination and the clinical studies. Results: The mean duration of symptoms was 18.956.50 months. The reason for referral was phonation changes (97.8%) and aspiration (37.8%) in the subjects. There was bilateral paralysis in 6.82%, left paralysis in 56.82% and right in 63.36% of subjects. The type of vocal cord placement was midline in 52.8%, paramedian in 44.4% and lateral in 2.8% of the subjects. The causes of vocal cords paralysis were idiopathic paralysis (31.11%), tumors (31.11%), surgery (28.89%), trauma, brain problems, systemic disease and other causes (2.2%). Conclusion: An integrated diagnostic and treatment program is necessary for patients with vocal cord paralysis. Possibility of malignancy should be excluded before marking idiopathic reason to vocal cord paralysis. PMID:24753832

  9. Hernia of Umbilical Cord: Report of Three Unusual Cases

    PubMed Central

    Mirza, Bilal; Mirza, Afzal; Hashim, Imran; Saleem, Muhammad

    2015-01-01

    Congenital hernia of umbilical cord is a less frequent entity in newborns and occasionally associated with other maladies. Herein, we report three unusual cases of hernia of umbilical cord. First case was associated with in-utero evisceration of entire small bowel through the presumably ruptured hernia of umbilical cord and other two cases had associated patent vitellointestinal duct (PVID). All of the cases were managed successfully. PMID:26034710

  10. Extensive Spinal Cord Injury following Staphylococcus aureus Septicemia and Meningitis

    PubMed Central

    De Schryver, Nicolas; Cosnard, Guy; van Pesch, Vincent; Godfraind, Catherine; Hantson, Philippe

    2011-01-01

    Bacterial meningitis is rarely complicated by spinal cord involvement in adults. We report a case of Staphylococcus aureus septicemia complicated by meningitis and extensive spinal cord injury, leading to ascending brain stem necrosis and death. This complication was investigated by magnetic resonance imaging which demonstrated intramedullary hyperintensity on T2-weighted images and by multimodality evoked potentials. Postmortem microscopic examination confirmed that the extensive spinal cord injury was of ischemic origin, caused by diffuse leptomeningitis and endarteritis. PMID:21738506

  11. Terrapin muscle afferents studied by cord dorsum potential analyses.

    PubMed

    Feenstra, B W; Schropp, R E

    1985-01-01

    Rostro-caudal ramification of terrapin hindlimb afferent nerves have been studied by cord dorsum potential analyses. Stimulation of muscle and cutaneous nerves evoke different waveforms, related to the difference in fibre diameter spectra. Afferents of small muscles enter the cord through one spinal nerve, while afferents of large muscles are connected to the cord by up to four spinal roots. In their entrance segment muscle afferents bifurcate into branches extending in rostral and caudal direction over at least three segments. PMID:2863056

  12. Spinal Myoclonus After Spinal Cord Injury

    PubMed Central

    Calancie, Blair

    2006-01-01

    Background/Objective: In the course of examining spinal motor function in many hundreds of people with traumatic spinal cord injury, we encountered 6 individuals who developed involuntary and rhythmic contractions in muscles of their legs. Although there are many reports of unusual muscle activation patterns associated with different forms of myoclonus, we believe that certain aspects of the patterns seen with these 6 subjects have not been previously reported. These patterns share many features with those associated with a spinal central pattern generator for walking. Methods: Subjects in this case series had a history of chronic injury to the cervical spinal cord, resulting in either complete (ASIA A; n = 4) or incomplete (ASIA D; n = 2) quadriplegia. We used multi-channel electromyography recordings of trunk and leg muscles of each subject to document muscle activation patterns associated with different postures and as influenced by a variety of sensory stimuli. Results: Involuntary contractions spanned multiple leg muscles bilaterally, sometimes including weak abdominal contractions. Contractions were smooth and graded and were highly reproducible in rate for a given subject (contraction rates were 0.30.5 Hz). These movements did not resemble the brief rapid contractions (ie, "jerks") ascribed to some forms of spinal myoclonus. For all subjects, the onset of involuntary muscle contraction was dependent upon hip angle; contractions did not occur unless the hips (and knees) were extended (ie, subjects were supine). In the 4 ASIA A subjects, contractions occurred simultaneously in all muscles (agonists and antagonists) bilaterally. In sharp contrast, contractions in the 2 ASIA D subjects were reciprocal between agonists and antagonists within a limb and alternated between limbs, such that movements in these 2 subjects looked just like repetitive stepping. Finally, each of the 6 subjects had a distinct pathology of their spinal cord, nerve roots, distal trunk, or thigh; in 4 of these subjects, treatment of the pathology eliminated the involuntary movements. Conclusion: The timing, distribution, and reliance upon hip angle suggest that these movement patterns reflect some elements of a central pattern generator for stepping. Emergence of these movements in persons with chronic spinal cord injury is extremely rare and appears to depend upon a combination of the more rostrally placed injury and a pathologic process leading to a further enhancement of excitability in the caudal spinal cord. PMID:17044393

  13. Bacterial kidney disease (Renibacterium salmoninarum)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bacterial kidney disease (BKD), caused by Renibacterium salmoninarum, is a prevalent disease of salmonid fish that impacts sustainable production for consumption and species conservation efforts. The disease is chronic in nature and mortality most often occurs in juvenile salmonids and prespawning a...

  14. Flu Season and Your Kidneys

    MedlinePLUS

    ... counter medications, you should always drink plenty of water and stay well hydrated. If you take anti-histamines or decongestants, you should avoid ... 04/02/2016 - 10:00am Buffalo, NY Your Kidneys and You at The Community ...

  15. Vitamin D and the Kidney

    PubMed Central

    Kumar, Rajiv; Tebben, Peter J.; Thompson, James R.

    2012-01-01

    The kidney is essential for the maintenance of normal calcium and phosphorus homeostasis. Calcium and inorganic phosphorus are filtered at the glomerulus, and are reabsorbed from tubular segments by transporters and channels which are regulated by 1?,25-dihydroxyvitamin (1?,25(OH)2D) and parathyroid hormone (PTH). The kidney is the major site of the synthesis of 1?,25(OH)2D under physiologic conditions, and is one of the sites of 24,25-dihydroxyvitamin D (24,25(OH)2D) synthesis. The activity of the 25(OH)D-1?-hydroxylase, the mixed function oxidase responsible for the synthesis of 1?,25(OH)2D, is regulated by PTH, 1?,25(OH)2D, fibroblast growth factor 23 (FGF23), inorganic phosphorus and other growth factors. Additionally, the vitamin D receptor which binds to, and mediates the activity of 1?,25(OH)2D, is widely distributed in the kidney. Thus, the kidney by regulating multiple transport and synthetic processes is indispensible in the maintenance of mineral homeostasis in physiological states. PMID:22426203

  16. Possible mechanisms of kidney repair

    PubMed Central

    Romagnani, Paola; Kalluri, Raghu

    2009-01-01

    In most adult epithelia the process of replacing damaged or dead cells is maintained through the presence of stem/progenitor cells, which allow epithelial tissues to be repaired following injury. Existing evidence strongly supports the presence of stem cells in the adult kidney. Indeed, recent findings provide evidence in favour of a role for intrinsic renal cells and against a physiological role for bone marrow-derived stem cells in the regeneration of renal epithelial cells. In addition, recent studies have identified a subset of CD24+CD133+ renal progenitors within the Bowman's capsule of adult human kidney, which provides regenerative potential for injured renal epithelial cells. Intriguingly, CD24+CD133+ renal progenitors also represent common progenitors of tubular cells and podocytes during renal development. Chronic injury causes dysfunction of the tubular epithelial cells, which triggers the release of fibrogenic cytokines and recruitment of inflammatory cells to injured kidneys. The rapid interposition of scar tissue probably confers a survival advantage by preventing infectious microorganisms from invading the wound, but prevents subsequent tissue regeneration. However, the existence of renal epithelial progenitors in the kidney suggests a possible explanation for the regression of renal lesions which has been observed in experimental animals and even in humans. Thus, manipulation of the wound repair process in order to shift it towards regeneration will probably require the ability to slow the rapid fibrotic response so that renal progenitor cells can allow tissue regeneration rather than scar formation. PMID:19558670

  17. Screening for Chronic Kidney Disease

    MedlinePLUS

    ... about one in every 10 adults in the United States. Most people with CKD also have diabetes, high blood pressure, or both. Other risk factors for CKD are older age, obesity, and a family history of kidney failure. Most people with CKD have ...

  18. HIV and chronic kidney disease

    PubMed Central

    Naicker, Saraladevi; Rahmania, Sadaf; Kopp, Jeffrey B.

    2015-01-01

    Chronic kidney disease (CKD) is a frequent complication of HIV infection, occurring in 3.548.5%, and occurs as a complication of HIV infection, other co-morbid disease and infections and as a consequence of therapy of HIV infection and its complications. The classic involvement of the kidney by HIV infection is HIV-associated nephropathy (HIVAN), occurring typically in young adults of African ancestry with advanced HIV disease in association with APOL1 high-risk variants. HIV-immune complex disease is the second most common diagnosis obtained from biopsies of patients with HIV-CKD. CKD is mediated by factors related to the virus, host genetic predisposition and environmental factors. The host response to HIV infection may influence disease phenotype through activation of cytokine pathways. With the introduction of antiretroviral therapy (ART), there has been a decline in the incidence of HIVAN, with an increasing prevalence of focal segmental glomerulosclerosis. Several studies have demonstrated the overall improvement in kidney function when initiating ART for HIV CKD. Progression to end stage kidney disease has been reported to be more likely when high grade proteinuria, severely reduced eGFR, hepatitis B and/C co-infection, diabetes mellitus, extensive glomerulosclerosis, and chronic interstitial fibrosis are present. Improved renal survival is associated with use of renin angiotensin system blockers and viral suppression. Many antiretroviral medications are partially or completely eliminated by the kidney and require dose adjustment in CKD. Certain drug classes, such as the protease inhibitors and the non-nucleoside reverse transcriptase inhibitors, are metabolized by the liver and do not require dose adjustment. HIV-infected patients requiring either hemo- or peritoneal dialysis, who are stable on ART, are achieving survival rates comparable to those of dialysis patients without HIV infection. Kidney transplantation has been performed successfully in HIV-infected patients; graft and patient survival appears to be similar to that of HIV-uninfected recipients. Early detection of kidney disease by implementation of screening on diagnosis of HIV infection and annual screening thereafter will have an impact on the burden of disease, together with access to ART to those who require it. Programs for prevention of HIV infection are essential to prevent this lethal disease.

  19. Kidney Tumors | Office of Cancer Genomics

    Cancer.gov

    Pediatric kidney tumors fall into four primary categories: Wilms tumors (~85% of all cases), clear cell sarcomas of the kidney (~5%), congenital mesoblastic nephromas (~4%), and rhabdoid tumors of the kidney (~3%). The TARGET initiative is investigating three of these tumor types.

  20. Overview of Kidney Diseases in Children

    MedlinePLUS

    ... Kidney Foundation United Network for Organ Sharing MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... PDF, 345 KB)​​​​​ Alternate Language URL Overview of Kidney Disease in Children Page Content On this page: ...

  1. Treatment Methods for Kidney Failure: Hemodialysis

    MedlinePLUS

    ... Life Options Rehabilitation Program National Kidney Foundation, Inc. Kidney and Urologic Disease Organizations Many organizations provide support ... KB)​​​​​ Alternate Language URL Español Treatment Methods for Kidney Failure: Hemodialysis Page Content On this page: When ...

  2. Cord Blood Transplantation: Can We Make it Better?

    PubMed

    Metheny, Leland; Caimi, Paolo; de Lima, Marcos

    2013-01-01

    Umbilical cord blood is an established source of hematopoietic stem cells for transplantation. It enjoys several advantages over bone marrow or peripheral blood, including increased tolerance for Human Leukocyte Antigen mismatches, decreased incidence of graft-versus-host disease, and easy availability. Unrelated cord blood does have limitations, however, especially in the treatment of adults. In the 24?years since the first umbilical cord blood transplant was performed, significant progress has been made, but delayed hematopoietic engraftment and increased treatment-related mortality remain obstacles to widespread use. Here we summarize the latest results of unrelated cord blood transplants, and review strategies under investigation to improve clinical outcomes. PMID:24062989

  3. Cord blood banking: what nurses and healthcare providers should know.

    PubMed

    Abdullah, Yasmin

    2011-01-01

    Although the use of embryonic stem cells to treat disease has caused much controversy, one type of stem cell treatment has slowly and steadily shown promise but has not engendered negative ethical media attention: the use of umbilical stem cells. Umbilical cord blood (UCB) contains stem cells that have already successfully treated a variety of diseases, including leukemias, lymphomas, hemoglobinopathies, immunodeficiencies, and disorders of metabolism; ongoing research continues to explore additional diseases for potential treatment. Cord blood can be stored in private banks or public banks. Private cord blood banks save cord blood for use by the family only, at a cost. Public cord blood banks accept donations and the cord blood is then used for the general public and/or research. A review of the literature finds that public banking is the preferred recommendation over private unless there is a known family member with a disease that can currently be treated with cord blood. This article discusses cord blood banking options as well as the ethical issues and barriers facing both healthcare providers and patients when dealing with cord blood banking. PMID:21918487

  4. Umbilical cord blood: a guide for primary care physicians.

    PubMed

    Martin, Paul L; Kurtzberg, Joanne; Hesse, Brett

    2011-09-15

    Umbilical cord blood stem cell transplants are used to treat a variety of oncologic, genetic, hematologic, and immunodeficiency disorders. Physicians have an important role in educating, counseling, and offering umbilical cord blood donation and storage options to patients. Parents may donate their infant's cord blood to a public bank, pay to store it in a private bank, or have it discarded. The federal government and many state governments have passed laws and issued regulations regarding umbilical cord blood, and some states require physicians to discuss cord blood options with pregnant women. Five prominent medical organizations have published recommendations about cord blood donation and storage. Current guidelines recommend donation of umbilical cord blood to public banks when possible, or storage through the Related Donor Cord Blood Program when a sibling has a disease that may require a stem cell transplant. Experts do not currently recommend private banking for unidentified possible future use. Step-by-step guidance and electronic resources are available to physicians whose patients are considering saving or donating their infant's umbilical cord blood. PMID:21916391

  5. Spinal cord herniation with characteristic bone change: a case report

    PubMed Central

    Imai, Tasuku; Nakane, Yukimi; Tachibana, Eiji; Ogura, Koichiro

    2015-01-01

    ABSTRACT Spinal cord herniation (SCH) is a rare disease characterized by herniation of the thoracic spinal cord through an anterior dural defect, presenting with progressive myelopathy. A case of a 69-year-old woman who presented with Brown-Sequard syndrome and a bone defect, in which an osteophyte created a hemisphere-like cavity with spinal cord herniation, is presented. The strangled spinal cord was released, and the defect was closed microsurgically using an artificial dural patch to prevent re-herniation. Postoperatively, the patient experienced gradual improvement in neurologic function. The SCH mechanism and surgical strategy are discussed. PMID:26412899

  6. Conkiss: Conformal Kidneys Sparing 3D Noncoplanar Radiotherapy Treatment for Pancreatic Cancer As an Alternative to IMRT

    SciTech Connect

    Sebestyen, Zsolt; Kovacs, Peter; Gulyban, Akos; Farkas, Robert; Bellyei, Szabolcs; Liposits, Gabor; Szigeti, Andras; Esik, Olga; Derczy, Katalin; Mangel, Laszlo

    2011-04-01

    When treating pancreatic cancer using standard (ST) 3D conformal radiotherapy (3D-CRT) beam arrangements, the kidneys often receive a higher dose than their probable tolerance limit. Our aim was to elaborate a new planning method that-similarly to IMRT-effectively spares the kidneys without compromising the target coverage. Conformal kidneys sparing (CONKISS) 5-field, noncoplanar plans were compared with ST plans for 23 consecutive patients retrospectively. Optimal beam arrangements were used consisting of a left- and right-wedged beam-pair and an anteroposterior beam inclined in the caudal direction. The wedge direction determination (WEDDE) algorithm was developed to adjust the adequate direction of wedges. The aimed organs at risk (OARs) mean dose limits were: kidney <12 Gy, liver <25 Gy, small bowels <30 Gy, and spinal cord maximum <45 Gy. Conformity and homogeneity indexes with z-test were used to evaluate and compare the different planning approaches. The mean dose to the kidneys decreased significantly (p < 0.05): left kidney 7.7 vs. 10.7 Gy, right kidney 9.1 vs. 11.7 Gy. Meanwhile the mean dose to the liver increased significantly (18.1 vs. 15.0 Gy). The changes in the conformity, homogeneity, and in the doses to other OARs were not significant. The CONKISS method balances the load among the OARs and significantly reduces the dose to the kidneys, without any significant change in the conformity and homogeneity. Using 3D-CRT the CONKISS method can be a smart alternative to IMRT to enhance the possibility of dose escalation.

  7. What Are the Key Statistics about Brain and Spinal Cord Cancers?

    MedlinePLUS

    ... and spinal cord tumors? What are the key statistics about brain and spinal cord tumors? The American ... cord tumors .” Visit the American Cancer Society’s Cancer Statistics Center for more key statistics. Last Medical Review: ...

  8. 78 FR 42026 - Petition for Rulemaking To Eliminate Accessible Cords on Window Covering Products

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... evaluating roman shades and roll-up shades, including looped pull cords, no inner cord stops, no tension devices, and failure to attach tension devices to a continuous loop cord. Petitioners assert that many...

  9. Simultaneous Brain–Cervical Cord fMRI Reveals Intrinsic Spinal Cord Plasticity during Motor Sequence Learning

    PubMed Central

    Cohen-Adad, Julien; Marchand-Pauvert, Veronique; Benali, Habib; Doyon, Julien

    2015-01-01

    The spinal cord participates in the execution of skilled movements by translating high-level cerebral motor representations into musculotopic commands. Yet, the extent to which motor skill acquisition relies on intrinsic spinal cord processes remains unknown. To date, attempts to address this question were limited by difficulties in separating spinal local effects from supraspinal influences through traditional electrophysiological and neuroimaging methods. Here, for the first time, we provide evidence for local learning-induced plasticity in intact human spinal cord through simultaneous functional magnetic resonance imaging of the brain and spinal cord during motor sequence learning. Specifically, we show learning-related modulation of activity in the C6–C8 spinal region, which is independent from that of related supraspinal sensorimotor structures. Moreover, a brain–spinal cord functional connectivity analysis demonstrates that the initial linear relationship between the spinal cord and sensorimotor cortex gradually fades away over the course of motor sequence learning, while the connectivity between spinal activity and cerebellum gains strength. These data suggest that the spinal cord not only constitutes an active functional component of the human motor learning network but also contributes distinctively from the brain to the learning process. The present findings open new avenues for rehabilitation of patients with spinal cord injuries, as they demonstrate that this part of the central nervous system is much more plastic than assumed before. Yet, the neurophysiological mechanisms underlying this intrinsic functional plasticity in the spinal cord warrant further investigations. PMID:26125597

  10. Weight Management Following SCI (Spinal Cord Injury)

    MedlinePLUS

    ... of developing kidney stones, and may decrease bone loss. in saturated and trans fats (any food having the word “hydrogenated” on its ... Acting impulsively Neck and or lower back pain Loss of appetite or ... shows that carrying extra fat around one’s midsection can have a negative effect ...

  11. Expansion Duroplasty Improves Intraspinal Pressure, Spinal Cord Perfusion Pressure, and Vascular Pressure Reactivity Index in Patients with Traumatic Spinal Cord Injury: Injured Spinal Cord Pressure Evaluation Study

    PubMed Central

    Phang, Isaac; Werndle, Melissa C.; Saadoun, Samira; Varsos, Georgios; Czosnyka, Marek; Zoumprouli, Argyro

    2015-01-01

    Abstract We recently showed that, after traumatic spinal cord injury (TSCI), laminectomy does not improve intraspinal pressure (ISP), spinal cord perfusion pressure (SCPP), or the vascular pressure reactivity index (sPRx) at the injury site sufficiently because of dural compression. This is an open label, prospective trial comparing combined bony and dural decompression versus laminectomy. Twenty-one patients with acute severe TSCI had re-alignment of the fracture and surgical fixation; 11 had laminectomy alone (laminectomy group) and 10 had laminectomy and duroplasty (laminectomy+duroplasty group). Primary outcomes were magnetic resonance imaging evidence of spinal cord decompression (increase in intradural space, cerebrospinal fluid around the injured cord) and spinal cord physiology (ISP, SCPP, sPRx). The laminectomy and laminectomy+duroplasty groups were well matched. Compared with the laminectomy group, the laminectomy+duroplasty group had greater increase in intradural space at the injury site and more effective decompression of the injured cord. In the laminectomy+duroplasty group, ISP was lower, SCPP higher, and sPRx lower, (i.e., improved vascular pressure reactivity), compared with the laminectomy group. Laminectomy+duroplasty caused cerebrospinal fluid leak that settled with lumbar drain in one patient and pseudomeningocele that resolved completely in five patients. We conclude that, after TSCI, laminectomy+duroplasty improves spinal cord radiological and physiological parameters more effectively than laminectomy alone. PMID:25705999

  12. Neurocontrol of Movement in Humans With Spinal Cord Injury.

    PubMed

    Dimitrijevic, Milan R; Danner, Simon M; Mayr, Winfried

    2015-10-01

    In this review of neurocontrol of movement after spinal cord injury, we discuss neurophysiological evidences of conducting and processing mechanisms of the spinal cord. We illustrate that external afferent inputs to the spinal cord below the level of the lesion can modify, initiate, and maintain execution of movement in absence or partial presence of brain motor control after chronic spinal cord injury. We review significant differences between spinal reflex activity elicited by single and repetitive stimulation. The spinal cord can respond with sensitization, habituation, and dis-habituation to regular repetitive stimulation. Therefore, repetitive spinal cord reflex activity can contribute to the functional configuration of the spinal network. Moreover, testing spinal reflex activity in individuals with motor complete spinal cord injury provided evidences for subclinical residual brain influence, suggesting the existence of axons traversing the injury site and influencing the activities below the level of lesion. Thus, there are two motor control models of chronic spinal cord injury in humans: "discomplete" and "reduced and altered volitional motor control." We outline accomplishments in modification and initiation of altered neurocontrol in chronic spinal cord injury people with epidural and functional electrical stimulation. By nonpatterned electrical stimulation of lumbar posterior roots, it is possible to evoke bilateral extension as well as rhythmic motor outputs. Epidural stimulation during treadmill stepping shows increased and/or modified motor activity. Finally, volitional efforts can alter epidurally induced rhythmic activities in incomplete spinal cord injury. Overall, we highlight that upper motor neuron paralysis does not entail complete absence of connectivity between cortex, brain stem, and spinal motor cells, but there can be altered anatomy and corresponding neurophysiological characteristics. With specific input to the spinal cord below the level of the lesion, the clinical status of upper motor neuron paralysis without structural modification can be modified, and movements can be initiated. Thus, external afferent input can partially replace brain control. PMID:26471132

  13. Molecular basis of vascular events following spinal cord injury

    PubMed Central

    Popa, F; Grigorean, VT; Onose, G; Sandu, A; Popescu, M; Burnei, G; Strambu, V; Popa, C

    2010-01-01

    The aim of this article is to analyze the effects of the molecular basis of vascular events following spinal cord injury and their contribution in pathogenesis. First of all, we reviewed the anatomy of spinal cord vessels. The pathophysiology of spinal cord injuries revealed two types of pathogenic mechanisms. The primary event, the mechanic trauma, results in a disruption of neural and vascular structures into the spinal cord. It is followed by secondary pathogenesis that leads to the progression of the initial lesion. We reviewed vascular responses following spinal cord injury, focusing on both primary and secondary events. The intraparenchymal hemorrhage is a direct consequence of trauma; it has a typical pattern of distribution into the contused spinal cord, inside the gray matter and, it is radially extended into the white matter. The intraparenchymal hemorrhage is restricted to the dorsal columns, into adjacent rostral and caudal spinal segments. Distribution of chronic lesions overlaps the pattern of the early intraparenchymal hemorrhage. We described the mechanisms of action, role, induction and distribution of the heme oxygenase isoenzymes 1 and 2. Posttraumatic inflammatory response contributes to secondary pathogenesis. We analyzed the types of cells participating in the inflammatory response, the moment of appearance after the injury, the decrease in number, and the nature of their actions. The disruption of the bloodspinal cord barrier is biphasic. It exposes the spinal cord to inflammatory cells and to toxic effects of other molecules. Endothelin 1 mediates oxidative stress into the spinal cord through the modulation of spinal cord blood flow. The role of matrix metalloproteinases in bloodspinal cord barrier disruption, inflammation, and angiogenesis are reviewed. PMID:20945816

  14. Isolation of mesenchymal stem cells from equine umbilical cord blood

    PubMed Central

    Koch, Thomas G; Heerkens, Tammy; Thomsen, Preben D; Betts, Dean H

    2007-01-01

    Background There are no published studies on stem cells from equine cord blood although commercial storage of equine cord blood for future autologous stem cell transplantations is available. Mesenchymal stem cells (MSC) have been isolated from fresh umbilical cord blood of humans collected non-invasively at the time of birth and from sheep cord blood collected invasively by a surgical intrauterine approach. Mesenchymal stem cells isolation percentage from frozen-thawed human cord blood is low and the future isolation percentage of MSCs from cryopreserved equine cord blood is therefore expectedly low. The hypothesis of this study was that equine MSCs could be isolated from fresh whole equine cord blood. Results Cord blood was collected from 7 foals immediately after foaling. The mononuclear cell fraction was isolated by Ficoll density centrifugation and cultured in a DMEM low glucose based media at 38.5C in humidified atmosphere containing 5% CO2. In 4 out of 7 samples colonies with MSC morphology were observed. Cellular morphology varied between monolayers of elongated spindle-shaped cells to layered cell clusters of cuboidal cells with shorter cytoplasmic extensions. Positive Alizarin Red and von Kossa staining as well as significant calcium deposition and alkaline phosphatase activity confirmed osteogenesis. Histology and positive Safranin O staining of matrix glycosaminoglycans illustrated chondrogenesis. Oil Red O staining of lipid droplets confirmed adipogenesis. Conclusion We here report, for the first time, the isolation of mesenchymal-like stem cells from fresh equine cord blood and their differentiation into osteocytes, chondrocytes and adipocytes. This novel isolation of equine cord blood MSCs and their preliminary in vitro differentiation positions the horse as the ideal pre-clinical animal model for proof-of-principle studies of cord blood derived MSCs. PMID:17537254

  15. Arterial Stiffness, Kidney Function, and Chronic Kidney Disease Progression

    PubMed Central

    Townsend, Raymond R.; Tomiyama, Hirofumi

    2013-01-01

    Arterial stiffness can nowadays be measured easily and noninvasively around the globe. Although well established as an independent predictor of cardiovascular events, less is known about the role of arterial stiffness in the progressive loss of kidney function once chronic kidney disease (CKD) is established. In addition to measures of arterial stiffness, a number of devices now noninvasively record the pulse profile from sites such as the radial artery and, using internal algorithms, are able to estimate central pressure profiles. Although these devices have generated much data on the prediction of cardiovascular events, e.g. measures of arterial stiffness, there is much less known about the predictive utility of these measures in CKD progression. In this review, we cover approaches to arterial stiffness as measured by pulse wave velocity and discuss measures of the systolic and diastolic contour of the pulse waveform vis--vis their relationship to declines in kidney function over time. We restrict our coverage to studies that have longitudinal data, but we also include a table of studies, which, to our knowledge, have only published cross-sectional data at this time. PMID:26587431

  16. Congenital spinal cord haemangioblastoma: another cause of spinal cord section syndrome in the newborn.

    PubMed Central

    Roig, M; Ballesca, M; Navarro, C; Ortega, A; Martorell, R; Fina, A

    1988-01-01

    A newborn infant with negative perinatal history and characteristic clinical findings of upper cervical spinal cord section is described. Metrizamide myelography performed on the 7th and 22nd days of life was negative. Peroneal somatosensory evoked responses showed a conduction block at the cervical level. Necropsy revealed a haemangioblastoma extending from levels C1 to C5. Images PMID:3216212

  17. Chronic kidney disease: global dimension and perspectives.

    PubMed

    Jha, Vivekanand; Garcia-Garcia, Guillermo; Iseki, Kunitoshi; Li, Zuo; Naicker, Saraladevi; Plattner, Brett; Saran, Rajiv; Wang, Angela Yee-Moon; Yang, Chih-Wei

    2013-07-20

    Chronic kidney disease is defined as a reduced glomerular filtration rate, increased urinary albumin excretion, or both, and is an increasing public health issue. Prevalence is estimated to be 8-16% worldwide. Complications include increased all-cause and cardiovascular mortality, kidney-disease progression, acute kidney injury, cognitive decline, anaemia, mineral and bone disorders, and fractures. Worldwide, diabetes mellitus is the most common cause of chronic kidney disease, but in some regions other causes, such as herbal and environmental toxins, are more common. The poorest populations are at the highest risk. Screening and intervention can prevent chronic kidney disease, and where management strategies have been implemented the incidence of end-stage kidney disease has been reduced. Awareness of the disorder, however, remains low in many communities and among many physicians. Strategies to reduce burden and costs related to chronic kidney disease need to be included in national programmes for non-communicable diseases. PMID:23727169

  18. Chronic kidney disease (CKD) in disadvantaged populations.

    PubMed

    Garcia-Garcia, Guillermo; Jha, Vivekanand; Tao Li, Philip Kam; Garcia-Garcia, Guillermo; Couser, William G; Erk, Timur; Zakharova, Elena; Segantini, Luca; Shay, Paul; Riella, Miguel C; Osafo, Charlotte; Dupuis, Sophie; Kernahan, Charles

    2015-02-01

    Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations. PMID:25713703

  19. Chronic kidney disease (CKD) in disadvantaged populations

    PubMed Central

    Garcia-Garcia, Guillermo; Jha, Vivekanand

    2015-01-01

    Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations. PMID:25713703

  20. ROBO2 restricts the nephrogenic field and regulates Wolffian duct-nephrogenic cord separation.

    PubMed

    Wainwright, Elanor N; Wilhelm, Dagmar; Combes, Alexander N; Little, Melissa H; Koopman, Peter

    2015-08-15

    ROBO2 plays a key role in regulating ureteric bud (UB) formation in the embryo, with mutations in humans and mice leading to supernumerary kidneys. Previous studies have established that the number and position of UB outgrowths is determined by the domain of metanephric mesenchymal Gdnf expression, which is expanded anteriorly in Robo2 mouse mutants. To clarify how this phenotype arises, we used high-resolution 3D imaging to reveal an increase in the number of nephrogenic cord cells, leading to extension of the metanephric mesenchyme field in Robo2-null mouse embryos. Ex vivo experiments suggested a dependence of this effect on proliferative signals from the Wolffian duct. Loss of Robo2 resulted in a failure of the normal separation of the mesenchyme from the Wolffian duct/ureteric epithelium, suggesting that aberrant juxtaposition of these two compartments in Robo2-null mice exposes the mesenchyme to abnormally high levels of proliferative stimuli. Our data suggest a new model in which SLIT-ROBO signalling acts not by attenuating Gdnf expression or activity, but instead by limiting epithelial/mesenchymal interactions in the nascent metanephros and restricting the extent of the nephrogenic field. These insights illuminate the aetiology of multiplex kidney formation in human individuals with ROBO2 mutations. PMID:26116176

  1. [Quality Control in Umbilical Cord Blood Bank

    PubMed

    Zhou, Sheng-Li; Song, Dao-Gang; Shen, Bai-Jun; Pan, Jie

    2001-03-01

    Recent clinical reports have demonstrated that the use of umbilical cord blood (UCB) opened a new source of stem cell for hematopoietic stem cell transplantation, leading to the development of cord blood banks world-wide. Prior to the large scale construction of UCB banks, quality control must be performed for health care providers and manufactures. With increasingly stringent regulatory requirement in blood industry, quality control is playing an important role in the operation of blood centers and stem cell laboratories. Reviewed the lectures in the biology of UCB and UCB banks published in recent years, our experiences were discussed in setting up Shandong blood bank to define process variables associated with the collection of UCB, to determine and optimize the procedures and materials used, to ascertain how UCB can be processed in clean room as mononucleated cell preparations, and to analyze using of long-term storage of UCB in research and clinic in the future. Our conclusions are: (1) the establishment of UCB banks for use in transplantation appears to be easy, effective and particularly suitable approach in China under cGMP conditions; (2) the procedures for volume reduction by closed and semi-automated blood processing system, SSP HLA typing, biocode and local computer net, microbiological tests and the 50 ml cryobags for storage constitute a cost efficient system for large-scale UCB banking; (3) the average of 60 ml UCB collection may contain sufficent marrow repopulating cells for children and most of adult recipients; and (4) hematopoietic stem and progenitor cells in cord blood have a more potent proliferative ability than those derived from bone marrow in cell expansion potentials. PMID:12578654

  2. Volume effects in Rhesus monkey spinal cord

    SciTech Connect

    Schultheiss, T.E. ); Stephens, L.C.; Price, R.E.; Ang, K.K.; Peters, L.J. )

    1994-04-30

    An experiment was conducted to test for the existence of a volume effect in radiation myelopathy using Rhesus monkeys treated with clinically relevant field sizes and fractionation schedules. Five groups of Rhesus monkeys were irradiated using 2.2 Gy per fraction to their spinal cords. Three groups were irradiated with 8 cm fields to total doses of 70.4, 77, and 83.6 Gy. Two additional groups were irradiated to 70.4 Gy using 4 and 16 cm fields. The incidence of paresis expressed within 2 years following the completion of treatment was determined for each group. Maximum likelihood estimation was used to determine parameters of a logistic dose response function. The volume effect was modeled using the probability model in which the probability of producing a lesion in an irradiated volume is governed by the probability of the occurrence of independent events. This is a two parameter model requiring only the estimates of the parameters of the dose-response function for the reference volume, but not needing any additional parameters for describing the volume effect. The probability model using a logistic dose-response function fits the data well with the D[sub 50] = 75.8 Gy for the 8-cm field. No evidence was seen for a difference in sensitivities for different anatomical levels of the spinal cord. Most lesions were type 3, combined white matter parenchymal and vascular lesions. Latent periods did not differ significantly from those of type 3 lesions in humans. The spinal cord exhibits a volume effect that is well described by the probability model. Because the dose response function for radiation myelopathy is steep, the volume effect is modest. The Rhesus monkey remains the animal model most similar to humans in dose response, histopathology, and latency for radiation myelopathy. 22 refs., 3 figs., 1 tab.

  3. Prognosis and Treatment of Spinal Cord Astrocytoma

    SciTech Connect

    Minehan, Kiernan J. Brown, Paul D.; Scheithauer, Bernd W.; Krauss, William E.; Wright, Michael P.

    2009-03-01

    Purpose: To identify the prognostic factors for spinal cord astrocytoma and determine the effects of surgery and radiotherapy on outcome. Methods and Materials: This retrospective study reviewed the cases of consecutive patients with spinal cord astrocytoma treated at Mayo Clinic Rochester between 1962 and 2005. Results: A total of 136 consecutive patients were identified. Of these 136 patients, 69 had pilocytic and 67 had infiltrative astrocytoma. The median follow-up for living patients was 8.2 years (range, 0.08-37.6), and the median survival for deceased patients was 1.15 years (range, 0.01-39.9). The extent of surgery included incisional biopsy only (59%), subtotal resection (25%), and gross total resection (16%). Patients with pilocytic tumors survived significantly longer than those with infiltrative astrocytomas (median overall survival, 39.9 vs. 1.85 years; p < 0.001). Patients who underwent resection had a worse, although nonsignificant, median survival than those who underwent biopsy only (pilocytic, 18.1 vs. 39.9 years, p = 0.07; infiltrative, 19 vs. 30 months, p = 0.14). Postoperative radiotherapy, delivered in 75% of cases, gave no significant survival benefit for those with pilocytic tumors (39.9 vs. 18.1 years, p = 0.33) but did for those with infiltrative astrocytomas (24 vs. 3 months; Wilcoxon p = 0.006). On multivariate analysis, pilocytic histologic type, diagnosis after 1984, longer symptom duration, younger age, minimal surgical extent, and postoperative radiotherapy predicted better outcome. Conclusion: The results of our study have shown that histologic type is the most important prognostic variable affecting the outcome of spinal cord astrocytomas. Surgical resection was associated with shorter survival and thus remains an unproven treatment. Postoperative radiotherapy significantly improved survival for patients with infiltrative astrocytomas but not for those with pilocytic tumors.

  4. Diaphragmatic pacing in spinal cord injury.

    PubMed

    Dalal, Kevin; DiMarco, Anthony F

    2014-08-01

    After cervical spinal cord injuries, many patients are unable to sustain independent ventilation because of a disruption of diaphragm innervation and respiratory functioning. If phrenic nerve function is preserved, the patient may be able to tolerate exogenous pacing of the diaphragm via electrical stimulation. Previously this was accomplished by stimulation directly to the phrenic nerves, but may be accomplished less invasively by percutaneously stimulating the diaphragm itself. The benefits, when compared with mechanical ventilation, include a lower rate of pulmonary complications, improved venous return, more normal breathing and speech, facilitation of eating, cost-effectiveness, and increased patient mobility. PMID:25064791

  5. Natural Polyphenols and Spinal Cord Injury

    PubMed Central

    Khalatbary, Ali Reza

    2014-01-01

    Polyphenols have been shown to have some of the neuroprotective effects against neurodegenerative diseases. These effects are attributed to a variety of biological activities, including free radical scavenging/antioxidant and anti-inflammatory and anti-apoptotic activities. In this regard, many efforts have been made to study the effects of various well-known dietary polyphenols on spinal cord injury (SCI) and to explore the mechanisms behind the neuroprotective effects. The aim of this paper is to present the mechanisms of neuroprotection of natural polyphenols used in animal models of SCI. PMID:24842137

  6. [Bilateral vocal cord paresis after total thyroidectomy].

    PubMed

    Dralle, H; Neu, J; Musholt, T J; Nies, C

    2016-01-01

    A 66-year-old female patient complained of hoarseness and dyspnea under exertion following total thyroidectomy. Due to a faulty operating technique both nerves to the vocal cords were damaged. From the operation report it emerged that the dissection was carried out by protecting the border lamellae but the recurrent laryngeal nerve could not be found on both sides. This article presents the external expert opinion, the decision of the arbitration board and the assessment of the case by two specialist physicians. PMID:26683653

  7. Immunotherapy strategies for spinal cord injury.

    PubMed

    Wang, Yong-Tang; Lu, Xiu-Min; Chen, Kai-Ting; Shu, Ya-Hai; Qiu, Chun-Hong

    2015-01-01

    Regeneration in the central nervous system (CNS) of adult mammalian after traumatic injury is limited, which often causes permanent functional motor and sensory loss. After spinal cord injury (SCI), the lack of regeneration is mainly attributed to the presence of a hostile microenvironment, glial scarring, and cavitation. Besides, inflammation has also been proved to play a crucial role in secondary degeneration following SCI. The more prominent treatment strategies in experimental models focus mainly on drugs and cell therapies, however, only a few strategies applied in clinical studies and therapies still have only limited effects on the repair of SCI. Recently, the interests in immunotherapy strategies for CNS are increasing in number and breadth. Immunotherapy strategies have made good progresses in treating many CNS degenerative disorders, such as Alzheimer's disease (AD), Parkinson's disease (PD), stroke, and multiple sclerosis (MS). However, the strategies begin to be considered to the treatment of SCI and other neurological disorders in recent years. Besides anti-inflamatory therapy, immunization with protein vaccines and DNA vaccines has emerged as a novel therapy strategy because of the simplicity of preparation and application. An inflammatory response followed by spinal cord injury, and is controled by specific signaling molecules, such as some cytokines playing a crucial role. As a result, appropriate immunoregulation, the expression of pro-inflammatory cytokines and anti-inflammatory cytokines may be an effective therapy strategy for earlier injury of spinal cord. In addition, myelinassociated inhibitors (MAIs) in the injured spinal cord, such as Nogo, myelin-associated glycoprotein (MAG) and oligodendrocyte- myelin glycoprotein (OMgp) are known to prevent axonal regeneration through their co-receptors, and to trigger demyelinating autoimmunity through T cell-mediated harmful autoimmune response. The antagonism of the MAIs through vaccinating with protein or DNA vaccines targeting Nogo, MAG, OMgp, and their co-receptors, may be an effective strategy for the treatment of SCI. However, immunotherapy such as anti-inflammtory therapy or vaccine targeting MAIs or their receptors, accompanied with the potential in risking autoimmune diseases. As a result, in order to optimize the anti-inflammtory therapy and design of protein or DNA vaccines for their use in the future clinical application, we need to further understand the possible mechanisms of neuroprotective immunity. This review presents recent advances in the development of immunotherapy strategies for the treatment of axonal degeneration and demyelination, and improvement of motor function after SCI. PMID:25860061

  8. Functional electrical stimulation and spinal cord injury.

    PubMed

    Ho, Chester H; Triolo, Ronald J; Elias, Anastasia L; Kilgore, Kevin L; DiMarco, Anthony F; Bogie, Kath; Vette, Albert H; Audu, Musa L; Kobetic, Rudi; Chang, Sarah R; Chan, K Ming; Dukelow, Sean; Bourbeau, Dennis J; Brose, Steven W; Gustafson, Kenneth J; Kiss, Zelma H T; Mushahwar, Vivian K

    2014-08-01

    Spinal cord injuries (SCI) can disrupt communications between the brain and the body, resulting in loss of control over otherwise intact neuromuscular systems. Functional electrical stimulation (FES) of the central and peripheral nervous system can use these intact neuromuscular systems to provide therapeutic exercise options to allow functional restoration and to manage medical complications following SCI. The use of FES for the restoration of muscular and organ functions may significantly decrease the morbidity and mortality following SCI. Many FES devices are commercially available and should be considered as part of the lifelong rehabilitation care plan for all eligible persons with SCI. PMID:25064792

  9. Treadmill step training promotes spinal cord neural plasticity after incomplete spinal cord injury

    PubMed Central

    Sun, Tiansheng; Ye, Chaoqun; Wu, Jun; Zhang, Zhicheng; Cai, Yanhua; Yue, Feng

    2013-01-01

    A large body of evidence shows that spinal circuits are significantly affected by training, and that intrinsic circuits that drive locomotor tasks are located in lumbosacral spinal segments in rats with complete spinal cord transection. However, after incomplete lesions, the effect of treadmill training has been debated, which is likely because of the difficulty of separating spontaneous stepping from specific training-induced effects. In this study, rats with moderate spinal cord contusion were jected to either step training on a treadmill or used in the model (control) group. The treadmill training began at day 7 post-injury and lasted 20 10 minutes per day, 5 days per week for 10 weeks. The speed of the treadmill was set to 3 m/min and was increased on a daily basis according to the tolerance of each rat. After 3 weeks of step training, the step training group exhibited a sig-nificantly greater improvement in the Basso, Beattie and Bresnahan score than the model group. The expression of growth-associated protein-43 in the spinal cord lesion site and the number of tyrosine hydroxylase-positive ventral neurons in the second lumbar spinal segment were greater in the step training group than in the model group at 11 weeks post-injury, while the levels of brain-derived neurotrophic factor protein in the spinal cord lesion site showed no difference between the two groups. These results suggest that treadmill training significantly improves functional re-covery and neural plasticity after incomplete spinal cord injury. PMID:25206564

  10. Plasticity of the Injured Human Spinal Cord: Insights Revealed by Spinal Cord Functional MRI

    PubMed Central

    Cadotte, David W.; Bosma, Rachael; Mikulis, David; Nugaeva, Natalia; Smith, Karen; Pokrupa, Ronald; Islam, Omar; Stroman, Patrick W.; Fehlings, Michael G.

    2012-01-01

    Introduction While numerous studies have documented evidence for plasticity of the human brain there is little evidence that the human spinal cord can change after injury. Here, we employ a novel spinal fMRI design where we stimulate normal and abnormal sensory dermatomes in persons with traumatic spinal cord injury and perform a connectivity analysis to understand how spinal networks process information. Methods Spinal fMRI data was collected at 3 Tesla at two institutions from 38 individuals using the standard SEEP functional MR imaging techniques. Thermal stimulation was applied to four dermatomes in an interleaved timing pattern during each fMRI acquisition. SCI patients were stimulated in dermatomes both above (normal sensation) and below the level of their injury. Sub-group analysis was performed on healthy controls (n?=?20), complete SCI (n?=?3), incomplete SCI (n?=?9) and SCI patients who recovered full function (n?=?6). Results Patients with chronic incomplete SCI, when stimulated in a dermatome of normal sensation, showed an increased number of active voxels relative to controls (p?=?0.025). There was an inverse relationship between the degree of sensory impairment and the number of active voxels in the region of the spinal cord corresponding to that dermatome of abnormal sensation (R2?=?0.93, p<0.001). Lastly, a connectivity analysis demonstrated a significantly increased number of intraspinal connections in incomplete SCI patients relative to controls suggesting altered processing of afferent sensory signals. Conclusions In this work we demonstrate the use of spinal fMRI to investigate changes in spinal processing of somatosensory information in the human spinal cord. We provide evidence for plasticity of the human spinal cord after traumatic injury based on an increase in the average number of active voxels in dermatomes of normal sensation in chronic SCI patients and an increased number of intraspinal connections in incomplete SCI patients relative to healthy controls. PMID:23029097

  11. Aging Biology in the Kidney.

    PubMed

    Bitzer, Markus; Wiggins, Jocelyn

    2016-01-01

    The notion that kidney function declines with age in the general population is well known in the Nephrology community and the average loss of glomerular filtration rate (GFR) about 1ml per year in most longitudinal studies. There is much debate within the community about whether this represents "normal aging" or whether this constitutes a form of renal disease. However this debate turns out, the real question is whether this decline is preventable - can it be modified or slowed? Efforts to find drivers of this decline are still in the very earliest stages, but have shown some promise at elucidating some of the pathologies involved. This article will address both the wider issue of the biology of aging as well as the specific pathologies of the aging kidney. PMID:26709058

  12. Genetic Basis for Kidney Cancer

    PubMed Central

    Pfaffenroth, Elizabeth Cartwright; Linehan, W. Marston

    2009-01-01

    Background Kidney cancer is not a homogenous entity; it is comprised of many different tumor types, with different biology, molecular mechanisms leading to disease, and therefore different treatment approaches. Objective To describe the genetic basis and biochemical pathways underlying inherited forms of renal cancer, specifically in four described syndromes (von Hippel-Lindau [VHL], Hereditary Papillary Renal Cancer [HPRC], Birt-Hogg-Dub [BHD], and Hereditary Leiomyomatosis Renal Cell Carcinoma [HLRCC]), and to elucidate how the understanding of these diseases enables the possibility for disease-specific approaches to therapy. Methods Systematic review of the published literature on inherited and sporadic forms of renal cancer. Conclusion Understanding of the biology and mechanisms of different forms of kidney cancer provides an opportunity for development of new treatment options. PMID:18476789

  13. Kidney Regeneration: Lessons from Development

    PubMed Central

    Chiba, Takuto; Hukriede, Neil; de Caestecker, Mark P.

    2015-01-01

    A number of genes involved in kidney development are reactivated in the adult after acute kidney injury (AKI). This has led to the belief that tissue repair mechanisms recapitulate pathways involved in embryonic development after AKI. We will discuss evidence to support this hypothesis by comparing the mechanisms of development with common pathways known to regulate post-AKI repair, or that we identified as cell-specific candidates based on public datasets from recent AKI translational profiling studies. We will argue that while many of these developmental pathways are reactivated after AKI, this is not associated with general cellular reprogramming to an embryonic state. We will show that reactivation of these developmental genes is often associated with expression in cells that are not normally involved in mediating parallel responses in the embryo, and that depending on the cellular context, these responses can have beneficial or detrimental effects on injury and repair after AKI. PMID:26120499

  14. Homocysteine in Chronic Kidney Disease.

    PubMed

    Ostrakhovitch, Elena A; Tabibzadeh, Siamak

    2015-01-01

    Hyperhomocysteinemia occurs in chronic- and end-stage kidney disease at the time when dialysis or transplant becomes indispensable for survival. Excessive accumulation of homocysteine (Hcy) aggravates conditions associated with imbalanced homeostasis and cellular redox thereby resulting in severe oxidative stress leading to oxidation of reduced free and protein-bound thiols. Thiol modifications such as N-homocysteinylation, sulfination, cysteinylation, glutathionylation, and sulfhydration control cellular responses that direct complex metabolic pathways. Although cysteinyl modifications are kept low, under Hcy-induced stress, thiol modifications persist thus surpassing cellular proteostasis. Here, we review mechanisms of redox regulation and show how cysteinyl modifications triggered by excess Hcy contribute development and progression of chronic kidney disease. We discuss different signaling events resulting from aberrant cysteinyl modification with a focus on transsulfuration. PMID:26471081

  15. Percutaneous Ablation in the Kidney

    PubMed Central

    Wood, Bradford J.; Gervais, Debra A.

    2011-01-01

    Percutaneous ablation in the kidney is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection. Its increasing use has been largely prompted by the rising incidental detection of renal cell carcinomas with cross-sectional imaging and the need to preserve renal function in patients with comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. Clinical studies to date indicate that radiofrequency ablation and cryoablation are effective therapies with acceptable short- to intermediate-term outcomes and with a low risk in the appropriate setting, with attention to pre-, peri-, and postprocedural detail. The results following percutaneous radiofrequency ablation and cryoablation in the treatment of renal cell carcinoma are reviewed in this article, including those of several larger scale studies of ablation of T1a tumors. Clinical and technical considerations unique to ablation in the kidney are presented, and potential complications are discussed. © RSNA, 2011 PMID:22012904

  16. Mesenchymal tumors of adult kidney.

    PubMed

    Samaratunga, Hemamali; Delahunt, Brett

    2015-03-01

    Mesenchymal tumors of the kidney, although infrequently encountered, constitute a wide spectrum of lesions. The relative rarity of these tumors means that in some instances criteria to differentiate between benign and malignancy are currently incompletely defined. More recently a variety of novel stromal tumors have been characterized, with hemangioblastoma and myopericytoma being notable examples. The identification of a subset of spindle cell tumors as synovial sarcoma, on the basis of the presence of a characteristic genetic translocation, has facilitated the correct classification of a number of tumors previously labeled as fibrosarcoma, malignant fibrous histiocytoma, or more recently cystic embryonal sarcoma. In this review, we have detailed the spectrum of both benign and malignant stromal tumors of the adult kidney, described the gross and microscopic features, with an emphasis on immunoexpression and the differential diagnosis of each tumor type. PMID:25773128

  17. The Hanging Cord with a Real Tip Mass

    ERIC Educational Resources Information Center

    Deschaine, J. S.; Suits, B. H.

    2008-01-01

    Normal mode solutions for the perfectly flexible hanging cord problem have been known for over 200 years. More recently, theoretical results for a hanging cord with a point mass attached were presented. Here the theoretical results are tested experimentally using high-precision techniques which are accessible for use in an introductory laboratory.

  18. Shriners Hospital Spinal Cord Injury Self Care Manual.

    ERIC Educational Resources Information Center

    Fox, Carol

    This manual is intended for young people with spinal cord injuries who are receiving rehabilitation services within the Spinal Cord Injury Unit at Shriners Hospital (San Francisco, California). An introduction describes the rehabilitation program, which includes family conferences, an individualized program, an independent living program,…

  19. Automatic Segmentation of Spinal Cord MRI Using Symmetric Boundary Tracing

    PubMed Central

    Mukherjee, Dipti Prasad; Cheng, Irene; Ray, Nilanjan; Mushahwar, Vivian; Lebel, Marc; Basu, Anup

    2011-01-01

    We develop an adaptive active contour tracing algorithm for extraction of spinal cord from MRI that is fully automatic, unlike existing approaches that need manually chosen seeds. We can accurately extract the target spinal cord and construct the volume of interest to provide visual guidance for strategic rehabilitation surgery planning. PMID:20529752

  20. Personal Adjustment Training for the Spinal Cord Injured

    ERIC Educational Resources Information Center

    Roessler, Richard; And Others

    1976-01-01

    This article describes experiences with Personal Achievement Skills (PAS), a group counseling process in a spinal cord injury project, emphasizing training in communication and goal setting in the context of group process. Issues in conducting such training and providing comprehensive service to the spinal cord injured are discussed in detail.…

  1. "Ex Corde Ecclesiae" and Catholic Higher Education in America

    ERIC Educational Resources Information Center

    Caridi, James A.

    2011-01-01

    This research assessed "Ex Corde Ecclesiae" within American Catholic higher education from the perspective of presidents and academicians who oversee or teach within theology or religious studies. Pope John Paul II's "Ex Corde Ecclesiae" outlines the theological essence of the Catholic University and details its specific responsibilities toward…

  2. [Prolapse of the umbilical cord--an intrapartum emergency situation].

    PubMed

    Stranz, G; Egashira, K

    1984-01-01

    There were 37 cases of prolapse of the umbilical cord among 16 177 deliveries (incidence of 0,2%). Therapy is firstly knee-chest positioning of the mother, control of fetal heart rate and acute tokolysis, secondly rapid delivery. The perinatal mortality of prolapsed cord was 13,5 per cent. Various methods of delivery are analysed. PMID:6516634

  3. Complete recovery of spinal cord compression following parathyroidectomy

    PubMed Central

    Ganesh, Alka; Kurian, Susy; John, Lily

    1981-01-01

    A case is reported of spinal cord compression at T2 level caused by a brown tumour of primary hyperparathyroidism involving the posterior arch of the vertebra. The spontaneous regression of cord compression following parathyroidectomy is documented clinically and radiologically. ImagesFig. 1Fig. 2 PMID:7335567

  4. Research using autologous cord blood - time for a policy change.

    PubMed

    Han, Michael X; Craig, Maria E

    2013-08-19

    • Type 1 diabetes results from the loss of normal immunological self-tolerance, which may be attributable to the failure of Foxp3+ regulatory T cells (Tregs). Umbilical cord blood is rich in Tregs and therefore has the potential to prevent or delay the onset of type 1 diabetes. A pilot trial is currently underway in Australia to examine whether infusion of autologous cord blood can prevent type 1 diabetes in high-risk children with serum antibodies to multiple β-cell antigens. • A number of other potential therapeutic indications for autologous cord blood have been proposed, including cerebral palsy and hypoxic-ischaemic encephalopathy. • Recruitment to clinical trials using cord blood is influenced by divergent public and private cord blood banking policy in Australia. The burgeoning consumer demand for storage of cord blood highlights the need for regulatory bodies to develop and adapt policies to facilitate research that may extend the use of cord blood beyond currently recognised indications. • Consumers, researchers and policymakers must also recognise specific ethical issues associated with collection and storage of cord blood, including storage in public and private banks, informed consent, ownership, access and the principle of beneficence. PMID:23984789

  5. OPTIMAL TIMING FOR CLAMPING THE UMBILICAL CORD AFTER BIRTH

    PubMed Central

    Raju, Tonse N. K.; Singal, Nalini

    2013-01-01

    Synopsis This paper provides a brief overview of pros and cons of clamping the cord too early (within seconds) after birth. It also highlights evolving data that suggests that delaying cord clamping for 30–60 seconds after birth is beneficial to the baby and the mother, with no measurable negative effects. PMID:23164185

  6. Liposarcoma of the spermatic cord: A case report

    PubMed Central

    Sambel, Murat; Demirbas, Murat; Yalcin, Omer; Erdogan, Abdullah; Oner, Sedat; Kilic, Metin; Aydos, Murat

    2015-01-01

    Spermatic cord liposarcoma is very rare and characterized by a painless inguinal or scrotal mass. This is a case report of a 66-year-old man presenting with a mass in his left scrotum. Inguinal orchiectomy was performed and the histopathological examination revealed a liposarcoma of the spermatic cord. PMID:26279732

  7. Shriners Hospital Spinal Cord Injury Self Care Manual.

    ERIC Educational Resources Information Center

    Fox, Carol

    This manual is intended for young people with spinal cord injuries who are receiving rehabilitation services within the Spinal Cord Injury Unit at Shriners Hospital (San Francisco, California). An introduction describes the rehabilitation program, which includes family conferences, an individualized program, an independent living program,

  8. Light chains and the kidney.

    PubMed Central

    Bradley, J R; Thiru, S; Evans, D B

    1987-01-01

    Five cases of renal impairment caused by the deposition of light chains in the kidney in association with various immunoproliferative disorders are reported. Light microscopy, immunohistochemistry, and electron microscopy were undertaken and different clinical courses were studied, resulting in variable influences of treatment. Light chain deposition is an important cause of renal impairment and requires special histological techniques for its recognition. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 PMID:3102562

  9. Kidney transplantation in obese patients.

    PubMed

    Tran, Minh-Ha; Foster, Clarence E; Kalantar-Zadeh, Kamyar; Ichii, Hirohito

    2016-03-24

    The World Health Organization estimated that in 2014, over 600 million people met criteria for obesity. In 2011, over 30% of individuals undergoing kidney transplant had a body mass index (BMI) 35 kg/m(2) or greater. A number of recent studies have confirmed the relationship between overweight/obesity and important comorbidities in kidney transplant patients. As with non-transplant surgeries, the rate of wound and soft tissue complications are increased following transplant as is the incidence of delayed graft function. These two issues appear to contribute to longer length of stay compared to normal BMI. New onset diabetes after transplant and cardiac outcomes also appear to be increased in the obese population. The impact of obesity on patient survival after kidney transplantation remains controversial, but appears to mirror the impact of extremes of BMI in non-transplant populations. Early experience with (open and laparoscopic) Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy support excellent weight loss (in the range of 50%-60% excess weight lost at 1 year), but experts have recommended the need for further studies. Long term nutrient deficiencies remain a concern but in general, these procedures do not appear to adversely impact absorption of immunosuppressive medications. In this study, we review the literature to arrive at a better understanding of the risks related to renal transplantation among individuals with obesity. PMID:27011911

  10. Controversies in kidney paired donation.

    PubMed

    Gentry, Sommer E; Montgomery, Robert A; Segev, Dorry L

    2012-07-01

    Kidney paired donation represented 10% of living kidney donation in the United States in 2011. National registries around the world and several separate registries in the United States arrange paired donations, although with significant variations in their practices. Concerns about ethical considerations, clinical advisability, and the quantitative effectiveness of these approaches in paired donation result in these variations. For instance, although donor travel can be burdensome and might discourage paired donation, it was nearly universal until convincing analysis showed that living donor kidneys can sustain many hours of cold ischemia time without adverse consequences. Opinions also differ about whether the last donor in a chain of paired donation transplants initiated by a nondirected donor should donate immediately to someone on the deceased donor wait-list (a domino or closed chain) or should be asked to wait some length of time and donate to start another sequence of paired donations later (an open chain); some argue that asking the donor to donate later may be coercive, and others focus on balancing the probability that the waiting donor withdraws versus the number of additional transplants if the chain can be continued. Other controversies in paired donation include simultaneous versus nonsimultaneous donor operations, whether to enroll compatible pairs, and interactions with desensitization protocols. Efforts to expand public awareness of and participation in paired donation are needed to generate more transplant opportunities. PMID:22732046

  11. Blood disorders after kidney transplantation.

    PubMed

    Reindl-Schwaighofer, Roman; Oberbauer, Rainer

    2014-04-01

    Post transplant anemia (PTA) is a common issue in kidney transplant recipients. Most importantly it is associated with an impaired allograft function. Other important factors associated with PTA are immunosuppressive drugs (MPA, AZA and SRL), iron deficiency, infections (Parvo B19), older donor age, rejection episodes, an increased inflammatory state, and erythropoietin hyporesponsiveness. As there are no adequately powered RCTs in the kidney transplant population on anemia treatment with ESA, we have to rely on what we know from the large RCTs in the CKD population. The recently published KDIGO guidelines do not recommend treatment with ESA if Hb is >10 g/dl. Repletion of iron stores is emphasized. Post transplant leukopenia (PTL) and thrombocytopenia (PTT) are frequent complications especially in the first six months after kidney transplantation. Myelosuppression caused by immunosuppressive agents (MPA, AZA, SRL, rATG), antimicrobial drugs (VGCV), and CMV infection is the predominant cause. There are no widely accepted guidelines on treatment strategies, but most often dose reduction or discontinuation of causative medication is done. Most clinicians tend to decrease MPA dose, but this is eventually associated with an increase in acute rejection episodes. VGCV dose reduction (preemptive treatment instead of CMV prophylaxis) may be a successful strategy. In severe cases G-CSF treatment is an important management option and seems to be safe. PMID:24211181

  12. Kidney transplantation in obese patients

    PubMed Central

    Tran, Minh-Ha; Foster, Clarence E; Kalantar-Zadeh, Kamyar; Ichii, Hirohito

    2016-01-01

    The World Health Organization estimated that in 2014, over 600 million people met criteria for obesity. In 2011, over 30% of individuals undergoing kidney transplant had a body mass index (BMI) 35 kg/m2 or greater. A number of recent studies have confirmed the relationship between overweight/obesity and important comorbidities in kidney transplant patients. As with non-transplant surgeries, the rate of wound and soft tissue complications are increased following transplant as is the incidence of delayed graft function. These two issues appear to contribute to longer length of stay compared to normal BMI. New onset diabetes after transplant and cardiac outcomes also appear to be increased in the obese population. The impact of obesity on patient survival after kidney transplantation remains controversial, but appears to mirror the impact of extremes of BMI in non-transplant populations. Early experience with (open and laparoscopic) Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy support excellent weight loss (in the range of 50%-60% excess weight lost at 1 year), but experts have recommended the need for further studies. Long term nutrient deficiencies remain a concern but in general, these procedures do not appear to adversely impact absorption of immunosuppressive medications. In this study, we review the literature to arrive at a better understanding of the risks related to renal transplantation among individuals with obesity. PMID:27011911

  13. Who regenerates the kidney tubule?

    PubMed

    Kramann, Rafael; Kusaba, Tetsuro; Humphreys, Benjamin D

    2015-06-01

    The kidney possesses profound regenerative potential and in some cases can recover completely 'restitutio at integrum' following an acute kidney injury (AKI). Emerging evidence strongly suggests that sometimes repair is incomplete, however, and, in this situation, an episode of AKI leads to future chronic kidney disease (CKD). Understanding the tubular response after AKI will shed light on the relationship between incomplete repair and future risk of CKD. The first repair phase after AKI is characterized by robust proliferation of epithelial cells in the proximal tubule. The exact source of these proliferating cells has been a source of controversy for the last decade. While nearly everyone now agrees that reparative cells arise within the proximal tubule, there is disagreement about whether all surviving cells possess an equivalent repair capacity through dedifferentiation, or alternatively whether a pre-existing intratubular stem cell population [so-called scattered tubular cells (STC)] is responsible for repair. This review will summarize the evidence on both sides of this issue and will discuss very recent genetic fate-tracing data that strongly points against the existence of intratubular stem cells but rather indicates that terminally differentiated proximal tubule epithelial cells undergo dedifferentiation upon injury to replace lost neighboring tubular epithelial cells through proliferative self-duplication. This new evidence includes data clearly indicating that STC are not committed tubular stem cells but instead represent individual dedifferentiated tubular epithelial cells that transiently express putative stem cell markers. PMID:25155054

  14. Pregnancy in chronic kidney disease.

    PubMed

    Vellanki, Kavitha

    2013-05-01

    Despite vast improvements in fetal outcomes, pregnancy in women with CKD is fraught with hazards; worsening of renal function and complications like preeclampsia and premature delivery are common. To date, there is no accurate formula to calculate glomerular filtration rate (GFR). Also, whether the current CKD classification is better than the older classification at predicting outcomes in pregnant women with CKD is unknown. Women with an estimated GFR ?1.4 mg/dL are at increased risk of progressive worsening of renal function regardless of the cause of the underlying kidney disease. Preeclampsia is difficult to diagnose in pregnant women with underlying CKD, and serum markers such as soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PIGF) may lead the way for definitive diagnosis. New-onset lupus or lupus flare is an indication for kidney biopsy during pregnancy; cyclosporine is safe and is the most effective agent that can be used during pregnancy. Women with adult polycystic kidney disease are at increased risk of hypertension and preeclampsia during pregnancy, as well as hepatic cysts later in life, the latter occurring with multiple pregnancies. Strict blood pressure control is important in pregnant women with diabetic nephropathy. A multidisciplinary team that includes nephrologists and obstetricians who deal with high-risk pregnancies should be involved in the care of pregnant women with CKD for successful pregnancy outcomes. PMID:23928386

  15. Autophagy in acute kidney injury.

    PubMed

    Kaushal, Gur P; Shah, Sudhir V

    2016-04-01

    Autophagy is a conserved multistep pathway that degrades and recycles damaged organelles and macromolecules to maintain intracellular homeostasis. The autophagy pathway is upregulated under stress conditions including cell starvation, hypoxia, nutrient and growth-factor deprivation, endoplasmic reticulum stress, and oxidant injury, most of which are involved in the pathogenesis of acute kidney injury (AKI). Recent studies demonstrate that basal autophagy in the kidney is vital for the normal homeostasis of the proximal tubules. Deletion of key autophagy proteins impaired renal function and increased p62 levels and oxidative stress. In models of AKI, autophagy deletion in proximal tubules worsened tubular injury and renal function, highlighting that autophagy is renoprotective in models of AKI. In addition to nonselective sequestration of autophagic cargo, autophagy can facilitate selective degradation of damaged organelles, particularly mitochondrial degradation through the process of mitophagy. Damaged mitochondria accumulate in autophagy-deficient kidneys of mice subjected to ischemia-reperfusion injury, but the precise mechanisms of regulation of mitophagy in AKI are not yet elucidated. Recent progress in identifying the interplay of autophagy, apoptosis, and regulated necrosis has revived interest in examining shared pathways/molecules in this crosstalk during the pathogenesis of AKI. Autophagy and its associated pathways pose potentially unique targets for therapeutic interventions in AKI. PMID:26924060

  16. Variable-Tension-Cord Suspension/Vibration-Isolation System

    NASA Technical Reports Server (NTRS)

    Villemarette, Mark L.; Boston, Joshua; RInks, Judith; Felice, Pat; Stein, Tim; Payne, Patrick

    2006-01-01

    A system for mechanical suspension and vibration isolation of a machine or instrument is based on the use of Kevlar (or equivalent aromatic polyamide) cord held in variable tension between the machine or instrument and a surrounding frame. The basic concept of such a tensioned-cord suspension system (including one in which the cords are made of aromatic polyamide fibers) is not new by itself; what is new here is the additional provision for adjusting the tension during operation to optimize vibration- isolation properties. In the original application for which this system was conceived, the objective is to suspend a reciprocating cryocooler aboard a space shuttle and to prevent both (1) transmission of launch vibrations to the cryocooler and (2) transmission of vibrations from the cryocooler to samples in a chamber cooled by the cryocooler. The basic mechanical principle of this system can also be expected to be applicable to a variety of other systems in which there are requirements for cord suspension and vibration isolation. The reciprocating cryocooler of the original application is a generally axisymmetric object, and the surrounding frame is a generally axisymmetric object with windows (see figure). Two cords are threaded into a spoke-like pattern between attachment rings on the cryocooler, holes in the cage, and cord-tension- adjusting assemblies. Initially, the cord tensions are adjusted to at least the level necessary to suspend the cryocooler against gravitation. Accelerometers for measuring vibrations are mounted (1) on the cold tip of the cryocooler and (2) adjacent to the cage, on a structure that supports the cage. During operation, a technician observes the accelerometer outputs on an oscilloscope while manually adjusting the cord tensions in an effort to minimize the amount of vibration transmitted to and/or from the cryocooler. A contemplated future version of the system would include a microprocessor-based control subsystem that would include cord-tension actuators. This control subsystem would continually adjust the cord tension in response to accelerometer feedback to optimize vibration-isolation properties as required for various operating conditions. The control system could also adjust cord tensions (including setting the two cords to different tensions) to suppress resonances. Other future enhancements could include optimizing the cord material, thickness, and braid; optimizing the spoke patterns; and adding longitudinal cords for applications in which longitudinal stiffness and vibration suppression are required.

  17. Cord Wood Testing in a Non-Catalytic Wood Stove

    SciTech Connect

    Butcher, T.; Trojanowski, R.; Wei, G.

    2014-06-30

    EPA Method 28 and the current wood stove regulations have been in-place since 1988. Recently, EPA proposed an update to the existing NSPS for wood stove regulations which includes a plan to transition from the current crib wood fuel to cord wood fuel for certification testing. Cord wood is seen as generally more representative of field conditions while the crib wood is seen as more repeatable. In any change of certification test fuel, there are questions about the impact on measured results and the correlation between tests with the two different fuels. The purpose of the work reported here is to provide data on the performance of a noncatalytic stove with cord wood. The stove selected has previously been certified with crib wood which provides a basis for comparison with cord wood. Overall, particulate emissions were found to be considerably higher with cord wood.

  18. Spinal cord ischemia is multifactorial: what is the best protocol?

    PubMed

    Melissano, Germano; Bertoglio, Luca; Mascia, Daniele; Rinaldi, Enrico; Del Carro, Ubaldo; Nardelli, Pasquale; Chiesa, Roberto

    2016-04-01

    Despite the improved understanding of spinal cord anatomy and spinal cord ischemia pathophysiology, the rate of debilitating postoperative paraparesis or paraplegia is still not negligible after procedures for thoracic or thoracoabdominal aortic disease. Single studies have demonstrated the role of different treatment modalities to prevent or treat spinal cord ischemia. A multimodal approach, however, is advocated by most authors. Even after the employment of endovascular techniques become routine, the rate of spinal cord ischemia after treatment of thoracoabdominal aortic pathology remained unchanged over time. Spinal cord ischemia is often treatable by different means that concur to improve indirect spinal perfusion through collateral circulation; it should, therefore, be managed promptly and aggressively due to its potential reversibility. Ongoing technical improvements of non-invasive diagnostic tools may allow a better preoperative assessment of the spinal vascular network and a better planning of both open and endovascular thoracic or thoracoabdominal repair. PMID:26731537

  19. Umbilical cord blood banking: beyond the public-private divide.

    PubMed

    O'Connor, Michelle A C; Samuel, Gabrielle; Jordens, Christopher F C; Kerridge, Ian H

    2012-03-01

    Umbilical cord blood is a source of haematopoietic progenitor cells, which are used to treat a range of malignant, genetic, metabolic and immune disorders. Until recently, cord blood was either collected through donations to publicly funded cord blood banks for use in allogeneic transplantation, or stored in commercial cord blood banks for use in autologous transplantation. The line between public and private cord blood banking is being blurred by the emergence of "hybrid" models that combine aspects of both the public and private systems. The authors describe these hybrid models and argue that their emergence is explained by both market forces and public sector policy They propose that the future of the sector will depend heavily on several key developments that will differentially affect public, private and hybrid banking models. PMID:22558903

  20. RhoA/Rho kinase in spinal cord injury

    PubMed Central

    Wu, Xiangbing; Xu, Xiao-ming

    2016-01-01

    A spinal cord injury refers to an injury to the spinal cord that is caused by a trauma instead of diseases. Spinal cord injury includes a primary mechanical injury and a much more complex secondary injury process involving inflammation, oxidation, excitotoxicity, and cell death. During the secondary injury, many signal pathways are activated and play important roles in mediating the pathogenesis of spinal cord injury. Among them, the RhoA/Rho kinase pathway plays a particular role in mediating spinal degeneration and regeneration. In this review, we will discuss the role and mechanism of RhoA/Rho kinase-mediated spinal cord pathogenesis, as well as the potential of targeting RhoA/Rho kinase as a strategy for promoting both neuroprotection and axonal regeneration. PMID:26981071

  1. Immunogenicity of umbilical cord tissue derived cells.

    PubMed

    Cho, Patricia S; Messina, Darin J; Hirsh, Erica L; Chi, Nina; Goldman, Stephanie N; Lo, Diana P; Harris, Ian R; Popma, Sicco H; Sachs, David H; Huang, Christene A

    2008-01-01

    Umbilical cord tissue provides a unique source of cells with potential for tissue repair. Umbilical cord tissue-derived cells (UTCs) are MHC class I (MHCI) dull and negative for MHC class II (MHCII), but can be activated to increase MHCI and to express MHCII with IFN-gamma stimulation. Mesenchymal stem cells with similar characteristics have been inferred to be nonimmunogenic; however, in most cases, immunogenicity was not directly assessed. Using UTC from Massachusetts General Hospital MHC-defined miniature swine, we assessed immunogenicity across a full MHC barrier. Immunogenicity was assessed by in vitro assays including mixed lymphocyte reaction (MLR) and flow cytometry to detect serum alloantibody. A single injection of MHC-mismatched unactivated UTCs did not induce a detectable immune response. When injected in an inflamed region, injected repeatedly in the same region or stimulated with IFN-gamma prior to injection, UTCs were immunogenic. As clinical cellular repair strategies may involve injection of allogeneic cells into inflamed regions of damaged tissue or repeated doses of cells to achieve the desired benefit, our results on the immunogenicity of these cells in these circumstances may have important implications for optimal success and functional improvement for this cellular treatment strategy for diseased tissues. PMID:17909081

  2. Neurogenic bladder in spinal cord injury patients

    PubMed Central

    Taweel, Waleed Al; Seyam, Raouf

    2015-01-01

    Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury. PMID:26090342

  3. Outcome Measures in Spinal Cord Injury

    PubMed Central

    Alexander, Marcalee S.; Anderson, Kim; Biering-Sorensen, Fin; Blight, Andrew R.; Brannon, Ruth; Bryce, Thomas; Creasey, Graham; Catz, Amiram; Curt, Armin; Donovan, William; Ditunno, John; Ellaway, Peter; Finnerup, Nanna B.; Graves, Daniel E.; Haynes, Beth Ann; Heinemann, Allen W.; Jackson, Amie B.; Johnston, Mark; Kalpakjian, Claire Z.; Kleitman, Naomi; Krassioukov, Andrei; Krogh, Klaus; Lammertse, Daniel; Magasi, Susan; Mulcahey, MJ; Schurch, Brigitte; Sherwood, Arthur; Steeves, John D.; Stiens, Steven; Tulsky, David S.; van Hedel, Hubertus J.A.; Whiteneck, Gale

    2009-01-01

    Study Design review by the Spinal Cord Outcomes Partnership Endeavor (SCOPE), which is a broad-based international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations. Objectives assessment of current and evolving tools for evaluating human spinal cord injury (SCI) outcomes for both clinical diagnosis and clinical research studies. Methods a framework for the appraisal of evidence of metric properties was used to examine outcome tools or tests for accuracy, sensitivity, reliability and validity for human SCI. Results imaging, neurological, functional, autonomic, sexual health, bladder/bowel, pain, and psycho-social tools were evaluated. Several specific tools for human SCI studies have or are being developed to allow the more accurate determination for a clinically meaningful benefit (improvement in functional outcome or quality of life) being achieved as a result of a therapeutic intervention. Conclusion significant progress has been made, but further validation studies are required to identify the most appropriate tools for specific targets in a human SCI study or clinical trial. PMID:19381157

  4. Neurogenic potential of spinal cord organotypic culture.

    PubMed

    Glazova, Margarita V; Pak, Elena S; Murashov, Alexander K

    2015-05-01

    There are several neurogenic niches in the adult mammalian central nervous system. In the central nervous system, neural stem cells (NSC) localize not only to the periventricular area, but are also diffusely distributed in the parenchyma. Here, we assessed neurogenic potential of organotypic cultures prepared from adult mouse spinal cord. Slices were placed on Millipore inserts for organotypic culture and incubated in neurobasal media supplemented with B27 and N2 for up to 9 weeks. After 3-4 weeks, the cell's aggregates formed in the slices. The aggregate's cells were BrdU-uptake, nestin and alkaline phosphatase positive. At the later stage of incubation, we observed Oct3/4 in the inner mass of the neurospheres as well as expression of Dppa1, which is an Oct-4 downstream target gene and a marker for pluripotency. To check differentiation, the formed neurospheres were isolated and cultured for several days in differentiation media. The obtained data demonstrated the cells from isolated neurospheres differentiate into astrocytes and MAP2-positive neurons. Immunostaining for HB9 and Lim2 revealed subsequent differentiation of MAP2-positive cells into motor neurons and interneurons, respectively. We hypothesized neuronal loss and/or long-term culturing of spinal cord slices may trigger a reset of the internal cell program and promote proliferation and further differentiation of NSC. PMID:25805458

  5. Subdural hematoma following spinal cord stimulator implant.

    PubMed

    Chiravuri, Srinivas; Wasserman, Ronald; Chawla, Amit; Haider, Naeem

    2008-01-01

    Headache following interventional procedures is a diagnostic challenge due to the multitude of possible etiologies involved. Presentation can be simple (PDPH alone) or complex (exacerbation of pre-existing chronic headache along with PDPH) or headache associated with a new onset intracranial process. Subdural hematoma is a rare complication of cranio-spinal trauma. Cranial subdural hematoma may present in an acute, sub-acute, or chronic fashion. Diagnosis of a subdural hematoma in the wake of a PDPH is difficult, requiring a high level of suspicion. Delayed diagnosis of subdural hematoma is usually related to failure to consider it in the differential diagnosis. Thorough history, assessment of the evolution of symptoms, and imaging studies may identify the possible cause and help direct treatment. Change in the character of initial presenting symptoms may be a sign of resolution of the headache or the onset of a secondary process. We report a case of acute intracranial subdural hematoma secondary to unintentional dural puncture during placement of a permanent spinal cord stimulator lead for refractory angina. There is need for careful follow-up of patients with a known post-dural tear. Failure to identify uncommon adverse events in patients with complicated spinal cord stimulator implantation may lead to permanent injury. PMID:18196176

  6. Recent developments in neurosurgical spinal cord monitoring.

    PubMed

    Schramm, J; Kurthen, M

    1992-09-01

    In a review 8 years ago, the then current status of intraoperative spinal cord monitoring (SCM) was discussed. Concerning future developments, that article concluded that the major challenge lay in (a) the improvement of the reliability and clinical relevance of somatosensory evoked potential (SEP) monitoring, where the incidence of false-negative and false-positive results had to be reduced, and (b) the application of new techniques like motor evoked potential (MEP) monitoring, which might turn out to be a method complementary to the SEP approach. Since that time, there has been a considerable amount of newly published results from intraoperative SCM, although clinical articles on exclusively neurosurgical SCM are rare (Table I). A selective literature search for the present review (primarily for the time from 1988 to 1992) yielded more than 200 citations. Eighty-one studies entered into the final evaluation; among these were 3 conference proceedings, 6 book chapters, and 10 review articles. Further, 40 clinical articles, and 22 articles on experimental work were counted. In particular, experimental studies in animals have given support to clinical monitoring by exploring the usefulness of new stimulation and recording techniques. This reappraisal only considers recent work on SEP and MEP in neurosurgical SCM with some experimental studies relevant to clinical SCM. Spinal cord monitoring in orthopaedic surgery is not evaluated in this review for reasons detailed in the article. PMID:1408337

  7. Spinal cord neuronal pathology in multiple sclerosis.

    PubMed

    Gilmore, Christopher P; DeLuca, Gabriele C; B, Lars; Owens, Trudy; Lowe, James; Esiri, Margaret M; Evangelou, Nikos

    2009-10-01

    The objective of this study was to assess neuronal pathology in the spinal cord in multiple sclerosis (MS), both within myelinated and demyelinated tissue. Autopsy material was obtained from 38 MS cases and 21 controls. Transverse sections were taken from three spinal cord levels and stained using Luxol Fast Blue/Cresyl Violet and myelin protein immunohistochemistry. Measurements of neuronal number and size were made for all neurons within the anterior horns of the gray matter. Neurons were classified as motoneurons or interneurons according to size criteria. In comparison with controls, both motoneuron and interneuron number were reduced in MS cases at the upper cervical (interneuron P = 0.0549; motoneuron P = 0.0073) and upper thoracic (interneuron P = 0.0507; motoneuron P = 0.0144), but not the lumbar level. Interneuron cross-sectional area was reduced in MS cases at all levels (upper cervical, P = 0.0000; upper thoracic, P = 0.0002; lumbar, P = 0.0337). Neuronal loss appears to be predominantly related to local gray matter plaques, whereas interneuron atrophy occurs in both myelinated and demyelinated areas. PMID:19170682

  8. Chicken Embryo Spinal Cord Slice Culture Protocol

    PubMed Central

    Price, Stephen R.

    2013-01-01

    Slice cultures can facilitate the manipulation of embryo development both pharmacologically and through gene manipulations. In this reduced system, potential lethal side effects due to systemic drug applications can be overcome. However, culture conditions must ensure that normal development proceeds within the reduced environment of the slice. We have focused on the development of the spinal cord, particularly that of spinal motor neurons. We systematically varied culture conditions of chicken embryo slices from the point at which most spinal motor neurons had been born. We assayed the number and type of motor neurons that survived during the culture period and the position of those motor neurons compared to that in vivo. We found that serum type and neurotrophic factors were required during the culture period and were able to keep motor neurons alive for at least 24 hr and allow those motor neurons to migrate to appropriate positions in the spinal cord. We present these culture conditions and the methodology of preparing the embryo slice cultures using eviscerated chicken embryos embedded in agarose and sliced using a vibratome. PMID:23568251

  9. Trochanteric pressure in spinal cord injury.

    PubMed

    Garber, S L; Campion, L J; Krouskop, T A

    1982-11-01

    Pressure-induced tissue breakdown is a frequent and life-threatening complication for individuals with spinal cord injury. These patients are frequently positioned on their sides to relieve back and sacral pressure while they are in bed. This position causes high trochanteric pressure with the potential for the development of pressure ulcers. In addition, the individual with a spinal cord injury has accompanying absent or diminished sensation, and therefore is not aware of the pressure overload. In this study the positions that will reduce the possibility that trochanteric ulcers will develop are identified. The Pressure Evaluation Pad (PEP), a pneumatic pressure monitoring system, has been used to study the effect of different leg positions on trochanteric pressure. The pressure under the right trochanter was monitored as the contralateral leg was positioned in various degrees of hip and knee flexion or extension. The procedure was repeated for the left trochanter. A study of 50 subjects demonstrated that a position of 30 degrees hip flexion and 35 degrees knee flexion (with lower leg behind midpoint of the body) produced lower contralateral trochanteric pressure than the traditional position of hip and knee flexion across the body. Additionally, thinner patients were found to have higher trochanteric pressure than average weight or obese subjects. Standardizing a method for the positioning of patients on their side can be a significant deterrent to the tissue erosion that greatly interferes with the rehabilitation process. PMID:7138267

  10. Bilateral Supernumerary Kidney: A Very Rare Presentation

    PubMed Central

    Keskin, Suat; Batur, Abdussamet; Keskin, Zeynep; Koc, Abdulkadir; Firat Ozcan, Irfan

    2014-01-01

    To our knowledge, bilateral supernumerary kidney is a very rare renal abnormality and there are five cases presented in the literature. It is difficult to diagnose supernumerary kidney and clinicians have not detected most cases preoperatively. Laboratory and imaging studies were acquired and carefully examined. The normal laboratory tests were found. Emergency ultrasonography was performed and they revealed no signs of parenchymal abnormality in both kidneys. Serial imaging study including enhanced computed tomography (CT) was performed. An imaging study identified bilateral supernumerary kidney with expanded collecting systems. On each side, significant rotation anomaly was found. In addition, there were two different renal arteries originating from the aorta. This report presents radiological determinations of supernumerary kidney bilaterally in a young man. We think that CT commonly appears to be enough for the diagnosis of supernumerary kidneys. PMID:25780543

  11. Acute kidney injury: an increasing global concern.

    PubMed

    Lameire, Norbert H; Bagga, Arvind; Cruz, Dinna; De Maeseneer, Jan; Endre, Zoltan; Kellum, John A; Liu, Kathleen D; Mehta, Ravindra L; Pannu, Neesh; Van Biesen, Wim; Vanholder, Raymond

    2013-07-13

    Despite an increasing incidence of acute kidney injury in both high-income and low-income countries and growing insight into the causes and mechanisms of disease, few preventive and therapeutic options exist. Even small acute changes in kidney function can result in short-term and long-term complications, including chronic kidney disease, end-stage renal disease, and death. Presence of more than one comorbidity results in high severity of illness scores in all medical settings. Development or progression of chronic kidney disease after one or more episode of acute kidney injury could have striking socioeconomic and public health outcomes for all countries. Concerted international action encompassing many medical disciplines is needed to aid early recognition and management of acute kidney injury. PMID:23727171

  12. The relationship between kidney and urinary kininogenase

    PubMed Central

    Nustad, K.

    1970-01-01

    1. Rat kidneys which were perfused with saline contained both kininogenase (KGA) and kininase activity. These activities were separated by gel filtration on a Sephadex G-100 column. The kininase activity was excluded from the column whereas the KGA activity was retained. Kidney KGA activity was primarily found in the sedimentable fraction of the homogenate. 2. The kidney KGA activity was compared with the urinary KGA activity, and the following properties were found to be the same: molecular dimension, pH optimum, effect of inhibitors, and ability to liberate kinins from kininogens. 3. A urinary sample collected over 24 h contained about 8 times the KGA activity found in the corresponding kidneys at the end of the collection period. The urine: kidney ratio for alkaline phosphatase was about 001. 4. The ability of kidney and urinary samples to hydrolyse N-?-benzoyl-L-arginine ethyl ester (BAEE) at pH 85 paralleled the KGA activity. PMID:5420147

  13. Potential advantages of acute kidney injury management by mesenchymal stem cells

    PubMed Central

    Bianchi, Francesca; Sala, Elisa; Donadei, Chiara; Capelli, Irene; La Manna, Gaetano

    2014-01-01

    Mesenchymal stem cells are currently considered as a promising tool for therapeutic application in acute kidney injury (AKI) management. AKI is characterized by acute tubular injury with rapid loss of renal function. After AKI, inflammation, oxidative stress and excessive deposition of extracellular matrix are the molecular events that ultimately cause the end-stage renal disease. Despite numerous improvement of supportive therapy, the mortality and morbidity among patients remain high. Therefore, exploring novel therapeutic options to treat AKI is mandatory. Numerous evidence in animal models has demonstrated the capability of mesenchymal stem cells (MSCs) to restore kidney function after induced kidney injury. After infusion, MSCs engraft in the injured tissue and release soluble factors and microvesicles that promote cell survival and tissue repairing. Indeed, the main mechanism of action of MSCs in tissue regeneration is the paracrine/endocrine secretion of bioactive molecules. MSCs can be isolated from several tissues, including bone marrow, adipose tissue, and blood cord; pre-treatment procedures to improve MSCs homing and their paracrine function have been also described. This review will focus on the application of cell therapy in AKI and it will summarize preclinical studies in animal models and clinical trials currently ongoing about the use of mesenchymal stem cells after AKI. PMID:25426262

  14. Incidentally diagnosed right-sided intrathoracic kidney

    PubMed Central

    Pandey, Jigyasa; Gujral, Ratni B; Kumar, Awanish

    2012-01-01

    Ectopic kidney is a well-known congenital anomaly. Intrathoracic kidney, as a form of renal ectopia, is an extremely rare entity. A 62-year-old man presented to the department of radiodiagnosis for evaluation of urinary problems. On the basis of ultrasonography, he was diagnosed to be having intrathoracic kidney, which was confirmed by CT scan. We present the details of the patient and brief review of the relevant literature. PMID:23060381

  15. Phosphatidylinositol 3-kinase signaling determines kidney size

    PubMed Central

    Chen, Jian-Kang; Nagai, Kojiro; Chen, Jianchun; Plieth, David; Hino, Masayo; Xu, Jinxian; Sha, Feng; Ikizler, T. Alp; Quarles, C. Chad; Threadgill, David W.; Neilson, Eric G.; Harris, Raymond C.

    2015-01-01

    Kidney size adaptively increases as mammals grow and in response to the loss of 1 kidney. It is not clear how kidneys size themselves or if the processes that adapt kidney mass to lean body mass also mediate renal hypertrophy following unilateral nephrectomy (UNX). Here, we demonstrated that mice harboring a proximal tubule–specific deletion of Pten (PtenptKO) have greatly enlarged kidneys as the result of persistent activation of the class I PI3K/mTORC2/AKT pathway and an increase of the antiproliferative signals p21Cip1/WAF and p27Kip1. Administration of rapamycin to PtenptKO mice diminished hypertrophy. Proximal tubule–specific deletion of Egfr in PtenptKO mice also attenuated class I PI3K/mTORC2/AKT signaling and reduced the size of enlarged kidneys. In PtenptKO mice, UNX further increased mTORC1 activation and hypertrophy in the remaining kidney; however, mTORC2-dependent AKT phosphorylation did not increase further in the remaining kidney of PtenptKO mice, nor was it induced in the remaining kidney of WT mice. After UNX, renal blood flow and amino acid delivery to the remaining kidney rose abruptly, followed by increased amino acid content and activation of a class III PI3K/mTORC1/S6K1 pathway. Thus, our findings demonstrate context-dependent roles for EGFR-modulated class I PI3K/mTORC2/AKT signaling in the normal adaptation of kidney size and PTEN-independent, nutrient-dependent class III PI3K/mTORC1/S6K1 signaling in the compensatory enlargement of the remaining kidney following UNX. PMID:25985273

  16. Subclinical Celiac Disease and Crystal-Induced Kidney Disease Following Kidney Transplant

    PubMed Central

    Capolongo, Giovanna; Abul-Ezz, Sameh; Moe, Orson W.; Sakhaee, Khashayar

    2015-01-01

    Decreased kidney function from kidney deposition of calcium oxalate has been previously described in inflammatory bowel disease as well as following jejuno-ileal and Roux-en-Y gastric bypass surgeries. Although celiac disease is the most prevalent bowel abnormality associated with intestinal malabsorption, its relationship to high kidney oxalate burden and decreased kidney function has not been established. We report a case of subclinical celiac disease and hyperoxaluria that presented with loss of kidney function as a result of high oxalate load in the absence of overt diarrhea, documented intestinal fat malabsorption, and nephrolithiasis. Subclinical celiac disease is commonly overlooked and hyperoxaluria is not usually investigated in kidney patients. We propose that this entity should be suspected in patients with chronic kidney disease in which the etiology of kidney damage has not been clearly established. PMID:22739230

  17. Kidney biomimicry--a rediscovered scientific field that could provide hope to patients with kidney disease.

    PubMed

    Stenvinkel, Peter; Johnson, Richard J

    2013-11-01

    Most studies on kidney disease have relied on classic experimental studies in mice and rats or clinical studies in humans. From such studies much understanding of the physiology and pathophysiology of kidney disease has been obtained. However, breakthroughs in the prevention and treatment of kidney diseases have been relatively few, and new approaches to fight kidney disease are needed. Here we discuss kidney biomimicry as a new approach to understand kidney disease. Examples are given of how various animals have developed ways to prevent or respond to kidney failure, how to protect themselves from hypoxia or oxidative stress and from the scourge of hyperglycemia. We suggest that investigation of evolutionary biology and comparative physiology might provide new insights for the prevention and treatment of kidney disease. PMID:24220764

  18. Wait too long to talk about kidney disease and you could be waiting for a kidney.

    MedlinePLUS

    ... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a ...

  19. 21 CFR 882.5880 - Implanted spinal cord stimulator for pain relief.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Implanted spinal cord stimulator for pain relief... Implanted spinal cord stimulator for pain relief. (a) Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to...

  20. 21 CFR 882.5880 - Implanted spinal cord stimulator for pain relief.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Implanted spinal cord stimulator for pain relief... Implanted spinal cord stimulator for pain relief. (a) Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to...

  1. 21 CFR 882.5880 - Implanted spinal cord stimulator for pain relief.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Implanted spinal cord stimulator for pain relief... Implanted spinal cord stimulator for pain relief. (a) Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to...

  2. 21 CFR 882.5880 - Implanted spinal cord stimulator for pain relief.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted spinal cord stimulator for pain relief... Implanted spinal cord stimulator for pain relief. (a) Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to...

  3. 21 CFR 882.5880 - Implanted spinal cord stimulator for pain relief.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Implanted spinal cord stimulator for pain relief... Implanted spinal cord stimulator for pain relief. (a) Identification. An implanted spinal cord stimulator for pain relief is a device that is used to stimulate electrically a patient's spinal cord to...

  4. Cooling athletes with a spinal cord injury.

    PubMed

    Griggs, Katy E; Price, Michael J; Goosey-Tolfrey, Victoria L

    2015-01-01

    Cooling strategies that help prevent a reduction in exercise capacity whilst exercising in the heat have received considerable research interest over the past 3 decades, especially in the lead up to a relatively hot Olympic and Paralympic Games. Progressing into the next Olympic/Paralympic cycle, the host, Rio de Janeiro, could again present an environmental challenge for competing athletes. Despite the interest and vast array of research into cooling strategies for the able-bodied athlete, less is known regarding the application of these cooling strategies in the thermoregulatory impaired spinal cord injured (SCI) athletic population. Individuals with a spinal cord injury (SCI) have a reduced afferent input to the thermoregulatory centre and a loss of both sweating capacity and vasomotor control below the level of the spinal cord lesion. The magnitude of this thermoregulatory impairment is proportional to the level of the lesion. For instance, individuals with high-level lesions (tetraplegia) are at a greater risk of heat illness than individuals with lower-level lesions (paraplegia) at a given exercise intensity. Therefore, cooling strategies may be highly beneficial in this population group, even in moderate ambient conditions (~21 C). This review was undertaken to examine the scientific literature that addresses the application of cooling strategies in individuals with an SCI. Each method is discussed in regards to the practical issues associated with the method and the potential underlying mechanism. For instance, site-specific cooling would be more suitable for an athlete with an SCI than whole body water immersion, due to the practical difficulties of administering this method in this population group. From the studies reviewed, wearing an ice vest during intermittent sprint exercise has been shown to decrease thermal strain and improve performance. These garments have also been shown to be effective during exercise in the able-bodied. Drawing on additional findings from the able-bodied literature, the combination of methods used prior to and during exercise and/or during rest periods/half-time may increase the effectiveness of a strategy. However, due to the paucity of research involving athletes with an SCI, it is difficult to establish an optimal cooling strategy. Future studies are needed to ensure that research outcomes can be translated into meaningful performance enhancements by investigating cooling strategies under the constraints of actual competition. Cooling strategies that meet the demands of intermittent wheelchair sports need to be identified, with particular attention to the logistics of the sport. PMID:25119157

  5. Intrinsically organized resting state networks in the human spinal cord

    PubMed Central

    Kong, Yazhuo; Eippert, Falk; Beckmann, Christian F.; Andersson, Jesper; Finsterbusch, Jrgen; Bchel, Christian; Tracey, Irene; Brooks, Jonathan C. W.

    2014-01-01

    Spontaneous fluctuations in functional magnetic resonance imaging (fMRI) signals of the brain have repeatedly been observed when no task or external stimulation is present. These fluctuations likely reflect baseline neuronal activity of the brain and correspond to functionally relevant resting-state networks (RSN). It is not known however, whether intrinsically organized and spatially circumscribed RSNs also exist in the spinal cord, the brains principal sensorimotor interface with the body. Here, we use recent advances in spinal fMRI methodology and independent component analysis to answer this question in healthy human volunteers. We identified spatially distinct RSNs in the human spinal cord that were clearly separated into dorsal and ventral components, mirroring the functional neuroanatomy of the spinal cord and likely reflecting sensory and motor processing. Interestingly, dorsal (sensory) RSNs were separated into right and left components, presumably related to ongoing hemibody processing of somatosensory information, whereas ventral (motor) RSNs were bilateral, possibly related to commissural interneuronal networks involved in central pattern generation. Importantly, all of these RSNs showed a restricted spatial extent along the spinal cord and likely conform to the spinal cords functionally relevant segmental organization. Although the spatial and temporal properties of the dorsal and ventral RSNs were found to be significantly different, these networks showed significant interactions with each other at the segmental level. Together, our data demonstrate that intrinsically highly organized resting-state fluctuations exist in the human spinal cord and are thus a hallmark of the entire central nervous system. PMID:25472845

  6. Impairment of spinal cord conduction velocity in diabetic rats.

    PubMed

    Carsten, R E; Whalen, L R; Ishii, D N

    1989-06-01

    Peripheral neuropathy is a common and well-studied complication of diabetes mellitus, but the possibility that central neuropathy is also present has received scant attention. Based on recent evidence showing that insulin has a direct effect on axon formation and neuronal survival in vitro, it was predicted that functional neuropathy would be present in the spinal cord of diabetic animals. Although structural lesions are encountered in the spinal cord of diabetic patients at autopsy, the functional corollaries have essentially remained unstudied. We used a new procedure to study evoked spinal cord potentials in the rat, which revealed a significant retardation in conduction velocity in streptozocin (STZ)-induced diabetic animals. This retardation was not due to a toxic effect of STZ on the involved spinal cord sensory pathways, because insulin infusion prevented the development of spinal cord neuropathy. The kinetics and magnitude of decline in conduction velocity were similar in the spinal cord, saphenous nerve, and common peroneal nerve during the first 2 wk, suggesting that a common mechanism was involved. After 10 wk, a spontaneous improvement in function was observed in the spinal cord and common peroneal nerve but not in the saphenous nerve. Our results support the hypothesis that central nervous system dysfunction can occur along with peripheral sensory neuropathy in diabetes. PMID:2656342

  7. [Stem cells of umbilical blood cord - therapeutic use].

    PubMed

    Bielec, Beata; Stojko, Rafa?

    2015-01-01

    For many years, the transplantation of hematopoietic stem cells has been used to treat some diseases of the hematopoietic system. For a very long time, only bone marrow was used as a source of hematopoietic stem cells for this method of treatment. However, to comply with allogeneic bone marrow transplantation, an antigenically compatible donor is necessary. Transplantations from unrelated donors are associated with increased risk of a graft-versus-host reaction, transplant rejection and, consequently, increased mortality. Many years ago, it was found that umbilical cord blood as well as bone marrow and peripheral blood contains hematopoietic stem cells and mesenchymal cells able to differentiate into different cell types and that the umbilical cord blood can be a source of stem cells for transplantation. Following this discovery, numerous attempts were made for its potential use in the treatment of hematologic diseases, metabolic diseases as well as regenerative medicine. Umbilical cord blood stem cells exhibit intermediate characteristics between embryonic and adult stem cells. They are distinguished from the latter by telomere length, telomerase activity, and lower risk of accumulation of DNA mutations or chromosomal aberrations. The only transplantation limitation appears to be the amount of cord blood collected, which on average is sufficient for transplantation in a 40-50 kg child. Collection of cord blood is a simple, short-lasting treatment, not causing any danger for a newborn or the mother. Umbilical cord blood is obtained during labor, and then frozen and stored at cord blood banks all over the world. PMID:26206998

  8. Curcumin protects against ischemic spinal cord injury: The pathway effect

    PubMed Central

    Zhang, Jinhua; Wei, Hao; Lin, Meimei; Chen, Chunmei; Wang, Chunhua; Liu, Maobai

    2013-01-01

    Inducible nitric oxide synthase and N-methyl-D-aspartate receptors have been shown to participate in nerve cell injury during spinal cord ischemia. This study observed a protective effect of curcumin on ischemic spinal cord injury. Models of spinal cord ischemia were established by ligating the lumbar artery from the left renal artery to the bifurcation of the abdominal aorta. At 24 hours after model establishment, the rats were intraperitoneally injected with curcumin. Reverse transcription-polymerase chain reaction and immunohistochemical results demonstrated that after spinal cord ischemia, inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression significantly increased. However, curcumin significantly decreased inducible nitric oxide synthase and N-methyl-D-aspartate receptor mRNA and protein expression in the ischemic spinal cord. Tarlov scale results showed that curcumin significantly improved motor function of the rat hind limb after spinal cord ischemia. The results demonstrate that curcumin exerts a neuroprotective fect against ischemic spinal cord injury by decreasing inducible nitric oxide synthase and N-methyl-D-aspartate receptor expression. PMID:25206661

  9. Glutamate receptors in the kidney.

    PubMed

    Dryer, Stuart E

    2015-10-01

    l-Glutamate (l-Glu) plays an essential role in the central nervous system (CNS) as an excitatory neurotransmitter, and exerts its effects by acting on a large number of ionotropic and metabotropic receptors. These receptors are also expressed in several peripheral tissues, including the kidney. This review summarizes the general properties of ionotropic and metabotropic l-Glu receptors, focusing on N-methyl-d-aspartate (NMDA) and Group 1 metabotropic glutamate receptors (mGluRs). NMDA receptors are expressed in the renal cortex and medulla, and appear to play a role in the regulation of renal blood flow, glomerular filtration, proximal tubule reabsorption and urine concentration within medullary collecting ducts. Sustained activation of NMDA receptors induces Ca(2+) influx and oxidative stress, which can lead to glomerulosclerosis, for example in hyperhomocysteinemia. Group 1 mGluRs are expressed in podocytes and probably in other cell types. Mice in which these receptors are knocked out gradually develop albuminuria and glomerulosclerosis. Several endogenous agonists of l-Glu receptors, which include sulfur-containing amino acids derived from l-homocysteine, and quinolinic acid (QA), as well as the co-agonists glycine and d-serine, are present in the circulation at concentrations capable of robustly activating ionotropic and metabotropic l-Glu receptors. These endogenous agonists may also be secreted from renal parenchymal cells, or from cells that have migrated into the kidney, by exocytosis or by transporters such as system x(-)(c), or by transporters involved in ammonia secretion. l-Glu receptors may be useful targets for drug therapy, and many selective orally-active compounds exist for investigation of these receptors as potential drug targets for various kidney diseases. PMID:25829324

  10. [Acute kidney injury in children].

    PubMed

    Amira-Peco-Anti?; Paripovi?, Dusan

    2014-01-01

    Acute kidney injury (AKI) is a clinical condition considered to be the consequence of a sudden decrease (> 25%) or discontinuation of renal function. The term AKI is used instead of the previous term acute renal failure, because it has been demonstrated that even minor renal lesions may cause far-reaching consequences on human health. Contemporary classifications of AKI (RIFLE and AKIN) are based on the change of serum creatinine and urinary output. In the developed countries, AKI is most often caused by renal ischemia, nephrotoxins and sepsis, rather than a (primary) diffuse renal disease, such as glomerulonephritis, interstitial nephritis, renovascular disorder and thrombotic microangiopathy. The main risk factors for hospital AKI are mechanical ventilation, use of vasoactive drugs, stem cell transplantation and diuretic-resistant hypervolemia. Prerenal and parenchymal AKI (previously known as acute tubular necrosis) jointly account for 2/3 of all AKI causes. Diuresis and serum creatinine concentration are not early diagnostic markers of AKI. Potential early biomarkers of AKI are neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney injury molecule-1 (KIM-1), interleukins 6, 8 and 18, and liver-type fatty acid-binding protein (L-FABP). Early detection of kidney impairment, before the increase of serum creatinine, is important for timely initiated therapy and recovery. The goal of AKI treatment is to normalize the fluid and electrolyte status, as well as the correction of acidosis and blood pressure. Since a severe fluid overload resistant to diuretics and inotropic agents is associated with a poor outcome, the initiation of dialysis should not be delayed. The mortality rate of AKI is highest in critically ill children with multiple organ failure and hemodynamically unstable patients. PMID:25033598

  11. The Kidney in Lead Poisoning

    PubMed Central

    Radoevi?, Zdenko; ari?, Marko; Beriti?, Tihomil; Kneevi?, Jelica

    1961-01-01

    Kidney damage due to lead is still an interesting problem of industrial toxicology. In spite of abundant literature data, much still remains to be explained. There are controversial opinions, not only on the type of renal lesions due to lead, but also on whether lead affects the kidney at all. In this paper our clinical observations on the effect of lead upon the kidney in 53 patients suffering from lead poisoning are presented. In 44 patients (40 men and four women) lead poisoning was due to occupation, and in nine (five men and four women) to the use of lead-glazed pottery. The length of exposure varied from two months to 35 years. In all cases the diagnosis of lead poisoning was made clinically and confirmed by laboratory tests. Permanent changes in the form of chronic nephropathy were observed in only two patients. These were the two cases in which exposure to lead was the longest and most intense. Twenty-three patients showed functional renal lesions tending to normalize. In addition to the cases of organic nephropathy, blood pressure was persistently raised in one further patient; in two patients a raised blood pressure was observed only in the acute stage of poisoning. On the basis of these findings we consider that lead intoxication can cause renal lesions. These lesions are for the most part functional and temporary. In cases of long and severe exposure and repeated lead intoxication, organic renal lesions seem possible. The disturbances of renal function observed in this study may be ascribed to disordered intrarenal circulation, due to the spastic effect of lead on intrarenal blood vessels, and to a direct toxic or indirect hypoxic effect of lead on the tubules. When investigating renal function, we have observed that the timing of individual tests is of paramount importance. Some lesions are subject to changes in the natural course of lead poisoning, and unless this is borne in mind, apparently contradictory results may be obtained. PMID:13739013

  12. Optical Coherence Tomography in Kidney Transplantation

    NASA Astrophysics Data System (ADS)

    Andrews, Peter M.; Wierwille, Jeremiah; Chen, Yu

    End-stage renal disease (ESRD) is associated with both high mortality rates and an enormous economic burden [1]. The preferred treatment option for ESRD that can extend patients' lives and improve their quality of life is kidney transplantation. However, organ shortages continue to pose a major problem in kidney transplantation. Most kidneys for transplantation come from heart-beating cadavers. Although non-heart-beating cadavers represent a potentially large pool of donor kidneys, these kidneys are not often used due to the unknown extent of damage to the renal tubules (i.e., acute tubular necrosis or "ATN") induced by ischemia (i.e., lack of blood flow). Also, ischemic insult suffered by kidneys awaiting transplantation frequently causes ATN that leads to varying degrees of delayed graft function (DGF) after transplantation. Finally, ATN represents a significant risk for eventual graft and patient survival [2, 3] and can be difficult to discern from rejection. In present clinical practice, there is no reliable real-time test to determine the viability of donor kidneys and whether or not donor kidneys might exhibit ATN. Therefore, there is a critical need for an objective and reliable real-time test to predict ATN to use these organs safely and utilize the donor pool optimally. In this review, we provided preliminary data indicating that OCT can be used to predict the post-transplant function of kidneys used in transplantation.

  13. The cell cycle and acute kidney injury

    PubMed Central

    Price, Peter M.; Safirstein, Robert L.; Megyesi, Judit

    2009-01-01

    Acute kidney injury (AKI) activates pathways of cell death and cell proliferation. Although seemingly discrete and unrelated mechanisms, these pathways can now be shown to be connected and even to be controlled by similar pathways. The dependence of the severity of renal-cell injury on cell cycle pathways can be used to control and perhaps to prevent acute kidney injury. This review is written to address the correlation between cellular life and death in kidney tubules, especially in acute kidney injury. PMID:19536080

  14. The Aging Kidney: Increased Susceptibility to Nephrotoxicity

    PubMed Central

    Wang, Xinhui; Bonventre, Joseph V.; Parrish, Alan R.

    2014-01-01

    Three decades have passed since a series of studies indicated that the aging kidney was characterized by increased susceptibility to nephrotoxic injury. Data from these experimental models is strengthened by clinical data demonstrating that the aging population has an increased incidence and severity of acute kidney injury (AKI). Since then a number of studies have focused on age-dependent alterations in pathways that predispose the kidney to acute insult. This review will focus on the mechanisms that are altered by aging in the kidney that may increase susceptibility to injury, including hemodynamics, oxidative stress, apoptosis, autophagy, inflammation and decreased repair. PMID:25257519

  15. Phenotype Standardization for Drug Induced Kidney Disease

    PubMed Central

    Mehta, Ravindra L; Awdishu, Linda; Davenport, Andrew; Murray, Patrick; Macedo, Etienne; Cerda, Jorge; Chakaravarthi, Raj; Holden, Arthur; Goldstein, Stuart L.

    2015-01-01

    Drug induced kidney disease is a frequent cause of renal dysfunction; however, there are no standards to identify and characterize the spectrum of these disorders. We convened a panel of international, adult and pediatric, nephrologists and pharmacists to develop standardized phenotypes for drug induced kidney disease as part of the phenotype standardization project initiated by the International Serious Adverse Events Consortium. We propose four phenotypes of drug induced kidney disease based on clinical presentation: acute kidney injury, glomerular, tubular and nephrolithiasis, along with primary and secondary clinical criteria to support the phenotype definition, and a time course based on the KDIGO/AKIN definitions of acute kidney injury, acute kidney disease and chronic kidney disease. Establishing causality in drug induced kidney disease is challenging and requires knowledge of the biological plausibility for the specific drug, mechanism of injury, time course and assessment of competing risk factors. These phenotypes provide a consistent framework for clinicians, investigators, industry and regulatory agencies to evaluate drug nephrotoxicity across various settings. We believe that this is first step to recognizing drug induced kidney disease and developing strategies to prevent and manage this condition. PMID:25853333

  16. Basics of kidney biopsy: A nephrologist's perspective

    PubMed Central

    Agarwal, S. K.; Sethi, S.; Dinda, A. K.

    2013-01-01

    The introduction of the kidney biopsy is one of the major events in the history of nephrology. Primary indications of kidney biopsy are glomerular hematuria/proteinuria with or without renal dysfunction and unexplained renal failure. Kidney biopsy is usually performed in prone position but in certain situations, supine and lateral positions may be required. Biopsy needles have changed with times from VimSilverman needle to Tru-cut needle to spring-loaded automatic gun. The procedure has also changed from blind bedside kidney biopsy to ultrasound marking to real-time ultrasound guidance to rarely computerized tomography guidance and laparoscopic and open biopsy. In very specific situations, transjugular kidney biopsy may be required. Most of the centers do kidney biopsy on short 1-day admission, whereas some take it as an outdoor procedure. For critical interpretation of kidney biopsy, adequate sample and clinical information are mandatory. Tissue needs to be stained with multiple stains for delineation of various components of kidney tissue. Many consider that electron microscopy (EM) is a must for all kidney biopsies, but facilities for EM are limited even in big centers. Sophisticated tests such as immunohistochemistry and in-situ hybridization are useful adjuncts for definitive diagnosis in certain situations. PMID:23960337

  17. Nutritional Management of Kidney Stones (Nephrolithiasis)

    PubMed Central

    Segal, Adam M.; Seifter, Julian L.; Dwyer, Johanna T.

    2015-01-01

    The incidence of kidney stones is common in the United States and treatments for them are very costly. This review article provides information about epidemiology, mechanism, diagnosis, and pathophysiology of kidney stone formation, and methods for the evaluation of stone risks for new and follow-up patients. Adequate evaluation and management can prevent recurrence of stones. Kidney stone prevention should be individualized in both its medical and dietary management, keeping in mind the specific risks involved for each type of stones. Recognition of these risk factors and development of long-term management strategies for dealing with them are the most effective ways to prevent recurrence of kidney stones. PMID:26251832

  18. Effect of cord blood processing on transplantation outcomes after single myeloablative umbilical cord blood transplantation.

    PubMed

    Ballen, Karen K; Logan, Brent R; Laughlin, Mary J; He, Wensheng; Ambruso, Daniel R; Armitage, Susan E; Beddard, Rachel L; Bhatla, Deepika; Hwang, William Y K; Kiss, Joseph E; Koegler, Gesine; Kurtzberg, Joanne; Nagler, Arnon; Oh, David; Petz, Lawrence D; Price, Thomas H; Quinones, Ralph R; Ratanatharathorn, Voravit; Rizzo, J Douglas; Sazama, Kathleen; Scaradavou, Andromachi; Schuster, Michael W; Sender, Leonard S; Shpall, Elizabeth J; Spellman, Stephen R; Sutton, Millicent; Weitekamp, Lee Ann; Wingard, John R; Eapen, Mary

    2015-04-01

    Variations in cord blood manufacturing and administration are common, and the optimal practice is not known. We compared processing and banking practices at 16 public cord blood banks (CBB) in the United States and assessed transplantation outcomes on 530 single umbilical cord blood (UCB) myeloablative transplantations for hematologic malignancies facilitated by these banks. UCB banking practices were separated into 3 mutually exclusive groups based on whether processing was automated or manual, units were plasma and red blood cell reduced, or buffy coat production method or plasma reduced. Compared with the automated processing system for units, the day 28 neutrophil recovery was significantly lower after transplantation of units that were manually processed and plasma reduced (red cell replete) (odds ratio, .19; P = .001) or plasma and red cell reduced (odds ratio, .54; P = .05). Day 100 survival did not differ by CBB. However, day 100 survival was better with units that were thawed with the dextran-albumin wash method compared with the "no wash" or "dilution only" techniques (odds ratio, 1.82; P = .04). In conclusion, CBB processing has no significant effect on early (day 100) survival despite differences in kinetics of neutrophil recovery. PMID:25543094

  19. Renal cell carcinoma in a natural remaining kidney after two kidney transplantations. Case report.

    PubMed

    Jekunen, A; Maiche, A; Rissanen, P; Virkkunen, P

    1994-06-01

    A 57-year-old woman with nephropathy following a streptococcal infection had received a kidney transplant in 1980 and 1986 and immunosuppressive treatment since 1980. Renal cell carcinoma was found in the right native kidney in 1991, with skeletal metastases. Nephrectomy was performed and radiotherapy given. Removal of non-functioning kidneys would prevent development of such cancer. PMID:7939471

  20. [Spinal cord stimulation - evidence and personal experience].

    PubMed

    Klein-Weigel, P

    2010-08-01

    Spinal cord stimulation (SCS) has been successfully used to treat chronic pain syndromes for decades. For this purpose, an electrode is implanted into the epidural space under local anaesthesia and connected to a neurostimulator which applies a weak direct current to the dorsal roots of the spinal column. Besides pain control, SCS increases the blood supply in the stimulated area. This effect is mediated by a sympathicolytic effect and the liberation of vasodilatators within the stimulated skin area. A Cochrane meta-analysis has revealed a significantly increased limb salvage rate in patients with non-reconstructable critical limb ischaemia (CLI) treated with SCS. The effect of SCS in CLI might be predicted by the measurement of forefoot transcutaneous pO (2) in supine and dependent positions, which renders trial stimulation unnecessary in many cases. PMID:20806142

  1. Spinal Cord Stimulation for Chronic Limb Ischemia

    PubMed Central

    Naoum, Joseph J.; Arbid, Elias J.

    2013-01-01

    The treatment of chronic limb ischemia involves the restoration of pulsatile blood flow to the distal extremity. Some patients cannot be treated with endovascular means or with open surgery; some may have medical comorbidities that render them unfit for surgery, while others may have persistent ischemia or pain even in the face of previous attempts at reperfusion. In spinal cord stimulation (SCS), a device with electrodes is implanted in the epidural space to stimulate sensory fibers. This activates cell-signaling molecules that in turn cause the release of vasodilatory molecules, a decrease in vascular resistance, and relaxation of smooth muscle cells. SCS also suppresses sympathetic vasoconstriction and pain transmission. When patient selection is based on microcirculatory parameters, SCS therapy can significantly improve pain relief, halt the progression of ulcers, and potentially achieve limb salvage. PMID:23805343

  2. Lidase treatment of spinal cord transected rats.

    PubMed

    Kowalski, T F; Vahlsing, H L; Feringa, E R

    1979-07-01

    Russian investigators have recently reported clinical recovery of enzyme treated, spinal cord transected rats. Using the exact protocols outlined by Matinian and Andreasian, we repeated a portion of their experiment using a Lidase preparation manufactured in the USSR. Animals were evaluated for return of bladder function, clinical evidence of hind limb motor function, cortical evoked response after sciatic nerve stimulation, and axonal transport of cortically injected tritiate proline by regenerated corticospinal axons. The only difference between treated and control animals was that the mean total body weight of the treated animals increased more than that of controls (p less than 0.05). No animal walked, had return of voluntary motor activity, showed cortical evoked response, or had evidence for transport of tritiated proline over regenerated corticospinal axons. PMID:507763

  3. How to Improve Cord Blood Engraftment?

    PubMed Central

    Beksac, Meral; Yurdakul, Pinar

    2016-01-01

    Various factors make cord blood (CB) a significant source of hematopoietic stem cells (HSCs), including ease of procurement and lack of donor attrition, with the ability to process and store the donor cells long term. Importantly, high proliferative potential of the immature HSCs allows one log less use of cells compared to bone marrow or peripheral blood stem cells. As total nucleated cell (TNC) and CD34+ cell content of CB grafts are correlated to engraftment rate and speed, strategies to expand HSC and homing have been developed. This chapter will focus only on modalities such as intrabone administration, fucosylation, CD26 inhibition, prostaglandin E2 derivative or complement 3 exposure, and SDF-1/CXCR4/CXCL-12 pathway interventions that have been experimented successfully. Furthermore, increasing evidence in line with better recognition of CB progenitors that are involved in engraftment and homing will also be addressed. PMID:26925402

  4. Intramedullary Spinal Cord Metastasis From Rectal Cancer

    PubMed Central

    Yang, Kyung Ho; Yi, Seong Yoon; Jung, Joo Hyuk; Kang, Seung Hee; Choi, Pyong Hwa

    2014-01-01

    Intramedullary spinal cord metastasis (ISCM) is an uncommon condition of the central nervous system (CNS) cause by systemic malignant tumors. Most ISCM cases are known to occur in patients with lung cancer and breast cancer; however, ISCM also very rarely occurs in patients with colorectal cancer. For the first time in Korea, we experienced a case of ISCM arising from rectal cancer, where a 75-year-old man presented with an abruptly-developed left-foot drop and numbness in both legs. The patient had lung metastases from rectal cancer that had been treated with chemotherapy. Magnetic resonance imaging revealed an intramedullary nodular lesion at the T12 level. ISCM was diagnosed and treated with steroids and radiotherapy. The patient's neurological symptoms were relieved for a while after treatment, but his condition deteriorated progressively. He died 4 months after ISCM had been diagnosed. PMID:25360432

  5. Medical treatment of acute spinal cord injuries.

    PubMed

    Ceylan, S; Kalelioğlu, M; Aktürk, G; Aktürk, F; Ceylan, S

    1990-01-01

    The injury was performed with 600 g-cm/weight on the spinal cord of 40 cats with T8-9 laminectomy in this study. Ten cats were given 10 mg/kg naloxone i.v. 1 h after injury. Ten cats were given 2 mg/kg thyrotropin-releasing hormone (TRH) i.v. 1 h after injury followed by 1 mg/kg per hour for 4 h. Intravenous lidocaine was begun 30 min after injury in ten cats, administered as 1.5 mg/kg over the initial 5 min, 3 mg/kg over the next 30 min and 1 mg/kg every 30 min for 4 h. The remaining ten cats were given only saline (control group). TRH-treated cats showed significantly better histopathological scores than either naloxone- or lidocaine-treated animals (KW:13.65, P less than 0.50). PMID:2112263

  6. Optogenetics Applications for Treating Spinal Cord Injury

    PubMed Central

    Ashraf, Sadia; Komai, Shoji

    2015-01-01

    Cases of spinal cord injury (SCI) are increasing all over the world; and in USA alone, there are 273,000 patients, which not only leads to morbidity and mortality but also results in a great economic burden. Many approaches are being used at the pre-clinical and clinical level to treat SCI including therapeutic agents, surgical decompression, stem cell therapy etc. Recently, a new approach called optogenetics has emerged in which light sensitive proteins are used to switch neurons on and off, and this approach has great potential to be used as therapy due to its specificity and rapid response in milliseconds. Few animal studies have been performed so far in which the respiratory and bladder function of rats was restored through the use of optogenetics. On the basis of promising results obtained, in the future, this approach can prove to be a valuable tool to treat patients with SCI. PMID:25901246

  7. Functional Electrical Stimulation and Spinal Cord Injury

    PubMed Central

    Ho, Chester H.; Triolo, Ronald J.; Elias, Anastasia L.; Kilgore, Kevin L.; DiMarco, Anthony F.; Bogie, Kath; Vette, Albert H.; Audu, Musa; Kobetic, Rudi; Chang, Sarah R.; Chan, K. Ming; Dukelow, Sean; Bourbeau, Dennis J.; Brose, Steven W.; Gustafson, Kenneth J.; Kiss, Zelma; Mushahwar, Vivian K.

    2015-01-01

    Synopsis Spinal cord injuries (SCI) can disrupt communications between the brain and the body, leading to a loss of control over otherwise intact neuromuscular systems. The use of electrical stimulation (ES) of the central and peripheral nervous system can take advantage of these intact neuromuscular systems to provide therapeutic exercise options, to allow functional restoration, and even to manage or prevent many medical complications following SCI. The use of ES for the restoration of upper extremity, lower extremity and truncal functions can make many activities of daily living a potential reality for individuals with SCI. Restoring bladder and respiratory functions and preventing pressure ulcers may significantly decrease the morbidity and mortality following SCI. Many of the ES devices are already commercially available and should be considered by all SCI clinicians routinely as part of the lifelong rehabilitation care plan for all eligible individuals with SCI. PMID:25064792

  8. [Spinal cord toxoplasmosis in HIV infection].

    PubMed

    Pittner, Y; Dufour, J-F; David, G; Boibieux, A; Peyramond, D

    2009-06-01

    We report the case of an atypical localization of a spinal cord "toxoplasmic abscess". The 46-year-old patient, HIV-1 positive, was admitted for acute urine retention and gait disorders. MRI revealed a T12-L1 medullary lesion suggesting a tumoral, inflammatory and infectious pathology. The radiological aspect and immunosuppression lead to the initiation of a treatment against Toxoplasma gondii, following the same treatment principles as for cerebral toxoplasmosis. The diagnosis can only be proved by data from autopsy or surgical biopsy, but toxoplasmosis PCR on CSF seems to be an interesting alternative to confirm the diagnosis. According to the literature, PCR is not sensitive enough as a diagnostic tool. Improvement after treatment supported the diagnosis confirmed by PCR. PMID:19304424

  9. 7T MRI of spinal cord injury.

    PubMed

    Cohen-Adad, Julien; Zhao, Wei; Wald, Lawrence L; Oaklander, Anne Louise

    2012-11-27

    A man with 25 years of mild left neck, arm, and leg paresthesias had initial MRI in 1996 identifying a left C3-4 dorsal horn cavernous hemangioma. In 1997, hemorrhage (C3-7) and resection induced left arm > leg proprioceptive loss and clumsiness. Three months after surgical resection, left upper-body pain recurred; 2 years later, disabling colocalizing itch recurred.(1) In 2012, ultra-high-resolution 7T MRI (figure) localized hemosiderin to specific dorsal horn laminae and detected rostral (C1-3) hypersignal invisible on conventional MRIs, most likely representing Wallerian degeneration.(2) These new imaging findings demonstrate the benefit of high-field spinal cord MRI and generate the hypothesis that his late-onset central itch might be related to delayed white matter degeneration. PMID:23183281

  10. Genetic control of Drosophila nerve cord development

    NASA Technical Reports Server (NTRS)

    Skeath, James B.; Thor, Stefan

    2003-01-01

    The Drosophila ventral nerve cord has been a central model system for studying the molecular genetic mechanisms that control CNS development. Studies show that the generation of neural diversity is a multistep process initiated by the patterning and segmentation of the neuroectoderm. These events act together with the process of lateral inhibition to generate precursor cells (neuroblasts) with specific identities, distinguished by the expression of unique combinations of regulatory genes. The expression of these genes in a given neuroblast restricts the fate of its progeny, by activating specific combinations of downstream genes. These genes in turn specify the identity of any given postmitotic cell, which is evident by its cellular morphology and choice of neurotransmitter.

  11. Will safety release cords on children's cameras prevent strangulation?

    PubMed

    Ridenour, Marcella V

    2003-12-01

    This study investigated the automatic safety release mechanisms on neck cords for children's cameras. The purpose of the safety release mechanism is to reduce accidental strangulation associated with children's toys that have neck cords. The horizontal pull forces that activate the automatic safety release mechanism were measured for two different styles of release mechanisms for neck cords. When these forces were compared to forces associated with child strangulation, the automatic safety mechanisms released at higher forces than the forces associated with accidental strangulation or death, which is contrary to what was intended and creates a false sense of security for parents who select a toy camera with such a device. PMID:14738371

  12. [In vitro cultivation of Plasmodium falciparum with umbilical cord erythrocyte].

    PubMed

    Li, C M; Su, T C

    1990-01-01

    Plasmodium falciparum was cultivated with umbilical cord erythrocytes or with erythrocytes from human adults for 33 days and 50 days respectively. The erythrocyte infection rate increased eightfold to eighteenfold at intervals of three to four days, the highest erythrocyte infection rate being more than 20%. Furthermore, the infection rate of umbilical cord erythrocytes was higher than that of adult erythrocytes at 48, 72 and 96 hours of cultivation, respectively (P less than 0.01). The results suggested that human umbilical cord blood might be a good source of erythrocytes for in vitro cultivation of malaria parasite. PMID:2099258

  13. Current therapeutic strategies for inflammation following traumatic spinal cord injury?

    PubMed Central

    Singh, Priyanka L.; Agarwal, Nitin; Barrese, James C.; Heary, Robert F.

    2012-01-01

    Damage from spinal cord injury occurs in two phases the trauma of the initial mechanical insult and a secondary injury to nervous tissue spared by the primary insult. Apart from damage sustained as a result of direct trauma to the spinal cord, the post-traumatic inflammatory response contributes significantly to functional motor deficits exacerbated by the secondary injury. Attenuating the detrimental aspects of the inflammatory response is a promising strategy to potentially ameliorate the secondary injury, and promote significant functional recovery. This review details how the inflammatory component of secondary injury to the spinal cord can be treated currently and in the foreseeable future. PMID:25624806

  14. Adult tethered cord syndrome resembling plantar fasciitis and peripheral neuropathy

    PubMed Central

    Amiri, Amir Reza; Kanesalingam, Kavitha; Srinivasan, Venkataramanan; Price, Rupert Francis

    2013-01-01

    Adult tethered cord syndrome without spinal dysraphism is rare, and can present with subtle symptoms that could mimic other pathologies. As a result, timely diagnosis of this condition has proved to be a significant challenge. It is crucial for clinicians to be aware of adult tethered cord syndrome and its presenting symptoms in order to achieve early diagnosis and subsequent management. We present such a case with particular attention to the presenting history and examination. Following diagnosis, the patient underwent a laminectomy and cord untethering, resulting in significant improvement to his symptoms. PMID:24311422

  15. 18F-FDG Hypermetabolism in Spinal Cord Schistosomiasis.

    PubMed

    Altinyay, Mustafa Erkan; Alharthi, Ashraf; Alassiri, Ali H; Syed, Ghulam Mustafa Shah

    2016-03-01

    A 24-year-old Saudi man presented with progressive lower-back pain for 3 months followed by lower-limb weakness, numbness, and urinary retention. Cerebrospinal fluid examination revealed high-protein, elevated white blood cell count with lymphocyte predominance. MRI scan of the spine demonstrated heterogeneously enhancing longitudinal spinal cord lesion from T6 through T9. FDG-PET/CT demonstrated prominently hypermetabolic lesion in the spinal cord. He had laminectomy and spinal cord (intramedullary) biopsy. Pathology revealed Schistosoma mansoni ova. PMID:26447373

  16. Internet-based atlas of the primate spinal cord.

    PubMed

    Tokuno, Hironobu; Tanaka, Ikuko; Senoo, Aya; Umitsu, Yoshitomo; Akazawa, Toshikazu; Nakamura, Yasuhisa; Watson, Charles

    2011-05-01

    In 2009, we reported an online brain atlas of the common marmoset (Callithrix jacchus) at http://marmoset-brain.org:2008. Here we report new digital images of the primate spinal cord sections added to the website. We prepared histological sections of every segment of the spinal cord of the common marmoset, rhesus monkey and Japanese monkey with various staining techniques. The sections were scanned with Carl Zeiss MIRAX SCAN at light microscopic resolution. Obtained digital data were processed and converted into multi-resolutionary images with Adobe Photoshop and Zoomify Design. These images of the primate spinal cords are now available on the web via the Internet. PMID:21291922

  17. Aminoterminal propeptide of type III procollagen in cord blood and amniotic fluid of high-risk pregnancies: a biochemical approach to the dynamic assessment of deviant fetal growth.

    PubMed

    Vanhaesebrouck, P; Kint, J; Van Kets, H; Govaert, P; Smets, K; Defoort, P; Leroy, J

    1994-07-01

    N-terminal propeptide of type III procollagen (PIIINP) concentration was measured in cord serum, amniotic fluid, and maternal serum from high-risk pregnancies. The fetal PIIINP variability was shown to be independent of the maternal serum PIIINP values. Although a highly significant negative correlation was found between the fetal propeptide level and gestational age in both appropriate-for-gestational-age neonates (n = 504) and small-for-gestational-age infants (n = 98), the PIIINP concentration in cord serum or amniotic fluid of small-for-gestational-age infants was significantly lower compared with that of appropriate-for-gestational-age infants matched for postconceptional age. PIIINP assay may thus serve as a dynamic biochemical indicator of deviant fetal growth. The PIIINP results were also related to the severity or duration of intrauterine growth retardation, as indicated by significantly lower propeptide cord serum values in nonmalformed small-for-gestational-age infants with small head circumference, known as an index for the chronicity of fetal nutritional deprivation. Preeclampsia, maternal diabetes or smoking, and congenital anomalies appeared not to be associated with any alteration of fetal propeptide concentration, provided they did not cause fetal growth deceleration. The finding of extremely high cord serum PIIINP values in six newborn infants with the Potter malformation sequence led to the speculation that large amounts of propeptides or their fragments usually are excreted by the fetal kidneys into the amniotic fluid. We suggest that determination of the PIIINP level in amniotic fluid or cord serum, obtained by amniocentesis and percutaneous umbilical sampling, may be a helpful adjunctive biochemical parameter in future research protocols assessing fetuses at risk for intrauterine growth retardation. PMID:7936841

  18. Vascular dysfunctions following spinal cord injury

    PubMed Central

    Popa, F; Grigorean, VT; Onose, G; Sandu, AM; Popescu, M; Burnei, G; Strambu, V; Sinescu, C

    2010-01-01

    The aim of this article is to analyze the vascular dysfunctions occurring after spinal cord injury (SCI). Vascular dysfunctions are common complications of SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. Neuroanatomy and physiology of autonomic nervous system, sympathetic and parasympathetic, is reviewed. SCI implies disruption of descendent pathways from central centers to spinal sympathetic neurons, originating in intermediolateral nuclei of T1L2 cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. SCI associates significant vascular dysfunction. Spinal shock occurs during the acute phase following SCI and it is a transitory suspension of function and reflexes below the level of the injury. Neurogenic shock, part of spinal shock, consists of severe arterial hypotension and bradycardia. Autonomic dysreflexia appears during the chronic phase, after spinal shock resolution, and it is a lifethreatening syndrome of massive imbalanced reflex sympathetic discharge occurring in patients with SCI above the splanchnic sympathetic outflow (T5T6). Arterial hypotension with orthostatic hypotension occurs in both acute and chronic phases. The etiology is multifactorial. We described a few factors influencing the orthostatic hypotension occurrence in SCI: sympathetic nervous system dysfunction, low plasma catecholamine levels, renninangiotensinaldosterone activity, peripheral alphaadrenoceptor hyperresponsiveness, impaired function of baroreceptors, hyponatremia and low plasmatic volume, cardiovascular deconditioning, morphologic changes in sympathetic neurons, plasticity within spinal circuits, and motor deficit leading to loss of skeletal muscle pumping activity. Additional associated cardiovascular concerns in SCI, such as deep vein thrombosis and longterm risk for coronary heart disease and systemic atherosclerosis are also described. Proper prophylaxis, including nonpharmacologic and pharmacological strategies, diminishes the occurrence of the vascular dysfunction following SCI. Each vascular disturbance requires a specific treatment. PMID:20945818

  19. Cardiac dysfunctions following spinal cord injury

    PubMed Central

    Sandu, AM; Popescu, M; Iacobini, MA; Stoian, R; Neascu, C; Popa, F

    2009-01-01

    The aim of this article is to analyze cardiac dysfunctions occurring after spinal cord injury (SCI). Cardiac dysfunctions are common complications following SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. We reviewed epidemiology of cardiac disturbances after SCI, and neuroanatomy and pathophysiology of autonomic nervous system, sympathetic and parasympathetic. SCI causes disruption of descendent pathways from central control centers to spinal sympathetic neurons, originating into intermediolateral nuclei of T1L2 spinal cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. SCI associates significant cardiac dysfunction. Impairment of autonomic nervous control system, mostly in patients with cervical or high thoracic SCI, causes cardiac dysrrhythmias, especially bradycardia and, rarely, cardiac arrest, or tachyarrhytmias and hypotension. Specific complication dependent on the period of time after trauma like spinal shock and autonomic dysreflexia are also reviewed. Spinal shock occurs during the acute phase following SCI and is a transitory suspension of function and reflexes below the level of the injury. Neurogenic shock, part of spinal shock, consists of severe bradycardia and hypotension. Autonomic dysreflexia appears during the chronic phase, after spinal shock resolution, and it is a lifethreatening syndrome of massive imbalanced reflex sympathetic discharge occurring in patients with SCI above the splanchnic sympathetic outflow (T5T6). Besides all this, additional cardiac complications, such as cardiac deconditioning and coronary heart disease may also occur. Proper prophylaxis, including nonpharmacologic and pharmacological strategies and cardiac rehabilitation diminish occurrence of the cardiac dysfunction following SCI. Each type of cardiac disturbance requires specific treatment. PMID:20108532

  20. Umbilical cord blood donation: public or private?

    PubMed

    Ballen, K K; Verter, F; Kurtzberg, J

    2015-10-01

    Umbilical cord blood (UCB) is a graft source for patients with malignant or genetic diseases who can be cured by allogeneic hematopoietic cell transplantation (HCT), but who do not have an appropriately HLA-matched family or volunteer unrelated adult donor. Starting in the 1990s, unrelated UCB banks were established, accepting donations from term deliveries and storing UCB units for public use. An estimated 730 000 UCB units have been donated and stored to date and ~35 000 UCB transplants have been performed worldwide. Over the past 20 years, private and family banks have grown rapidly, storing ~4 million UCB units for a particular patient or family, usually charging an up-front and yearly storage fee; therefore, these banks are able to be financially sustainable without releasing UCB units. Private banks are not obligated to fulfill the same regulatory requirements of the public banks. The public banks have released ~30 times more UCB units for therapy. Some countries have transitioned to an integrated banking model, a hybrid of public and family banking. Today, pregnant women, their families, obstetrical providers and pediatricians are faced with multiple choices about the disposition of their newborn's cord blood. In this commentary, we review the progress of UCB banking technology; we also analyze the current data on pediatric and adult unrelated UCB, including the recent expansion of interest in transplantation for hemoglobinopathies, and discuss emerging studies on the use of autologous UCB for neurologic diseases and regenerative medicine. We will review worldwide approaches to UCB banking, ethical considerations, criteria for public and family banking, integrated banking ideas and future strategies for UCB banking. PMID:26030051