Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent cell biologic studies of protein trafficking, sorting, and distribution in polarized renal epithelial cells have begun to provide important new insights into the mechanisms involved in generating and maintaining cell surface polarity. Advances in this field have been rapid in the last year, due in part to the development of new approaches to analyzing protein delivery and distribution in polarized renal cells grown in vitro. Sorting signals within apical and basal-lateral membrane proteins have been described that may be involved in the segregation of proteins into different populations of transport vesicles in the trans-Golgi network; the nature of these signals has provided insight into the mechanisms involved. Elements of the cytoskeleton appear to be involved in the delivery of these transport vesicles to the appropriate membrane domain (microtubules) and in the retention of specific proteins in the correct membrane domain (membrane skeleton). Finally, detailed analysis of two prominent renal diseases, ischemia and polycystic kidney disease, indicates that abnormalities in the regulation of membrane protein distribution may be a contributing factor in generating the disease state.
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PMID:Renal epithelial cell polarity. 136 32

We report a case of erythrocytosis in a patient with end-stage renal failure on chronic hemodialysis. The patient with polycystic kidney disease had an average Hb level of 10 g/dl while on hemodialysis for 3 years. He developed erythrocytosis (Hb 17.6 g/dl) following a cadaveric renal transplantation. No signs suggesting polycythemia vera were found. Nonrenal causes of secondary erythrocytosis such as anoxia, hemoglobinopathies or tumors were excluded. Angiography showed renal artery occlusion of the native kidney. Serum erythropoietin level was 85 U/l (normal 52 +/- 31 U/l) as measured by 3H-thymidine uptake. It is suggested that ischemia caused by the renal artery thrombosis stimulated the erythropoietin production in the native polycystic kidney.
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PMID:Erythrocytosis associated with renal artery thrombosis in a patient with polycystic kidney disease on hemodialysis. 211 27

A retrospective analysis of 88 patients operated upon with an arteriovenous fistula in the cubital fossa was made. At operation the intention was to construct a side-to-side fistula between a suitable vein and the brachial artery with an anastomosis length of 7-9 mm. 17 fistulae (19%) failed within three months, mainly due to occlusion. After one and four years, respectively, one-half and one-third of the fistulae at risk were in use. Patients with polycystic kidney disease had a worse prognosis regarding fistula function as well as those operated on with side-to-end technique. A patent cephalic vein in the upper arm was a favourable condition. Diabetic patients had a high risk of developing ischemia of the hand (25%), while this risk was low for patients with other diagnoses. Only one case developed heart decompensation, and 3 needed a flow reducing procedure. The method is thus less likely to function well in diabetics and in patients without a patent cephalic vein at the upper arm.
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PMID:Limitations of the use of arteriovenous fistulae in the cubital fossa. 793 61

von Meyenburg complexes (VMC) are dilated small bile ducts surrounded by fibrous stroma. These lesions are frequently seen at autopsy, especially in association with polycystic disease of the kidney and/or liver. The purpose of this study was to quantitate the prevalence of VMC and associated lesions, with a view to clarifying the nature of VMC. We examined the liver slides from 2843 autopsies and found 157 patients having VMC or cysts in the liver. For each of the 157 patients, and age- and gender-matched controls, VMC, hepatic cysts, and gross and microscopic renal cysts were counted and measured and autopsy reports were reviewed. VMC were found in 5.6% of adults and in 0.9% of children. Macroscopic hepatic cysts were found in 16.9% of livers that also had VMC. Of livers with hepatic cysts, 73.5% also had VMC. Adult polycystic kidney disease (APKD) was found in 11% of adults with at least one VMC and in 40% of those with four or more VMC. Among adults with APKD, VMC were found in 97% and hepatic cysts in 88%. Because APKD could account for only 11% of the patients with VMC, we suggest that VMC, in the absence of APKD, are a manifestation of a different disease, which could be genetic or secondary to inflammation or ischemia.
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PMID:The hepatic von Meyenburg complex: prevalence and association with hepatic and renal cysts among 2843 autopsies [corrected]. 868 20

Nephrologists are now investigating the involvement of apoptosis, or programmed cell death, in various renal diseases. Evidence suggests that abnormalities of apoptosis may contribute to the development of glomerular and tubular diseases. In tissue remodeling after glomerular injuries, excess apoptosis may be associated with cell deletion of glomerular sclerosis. Increased apoptosis may mediate the resolution of glomerular hypercellularity in experimental mesangial proliferation. Reactive oxygen species, deprivation of growth factors, anti-Thy 1 monoclonal antibodies and anti-Fas antibodies are capable of inducing apoptosis in cultured mesangial cells. In renal tubular diseases, apoptosis may be associated with tubular atrophy after ureteral obstruction, tubular damage after ischemia-reperfusion or toxic drugs, and the development of polycystic kidney disease. Infiltrative leukocytes in the glomerulus and renal interstitium undergo apoptosis during inflammation. Thus, apoptosis appears to play a significant role in many renal diseases, and we should consider the regulation of apoptosis in the treatment of these disorders.
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PMID:[Role of apoptosis in renal injury]. 874 98

Nonocclusive mesenteric infarction has recently been diagnosed with increasing frequency in dialysis patients. Although most reports have concerned patients on hemodialysis, the condition has also been reported to occur in patients on continuous ambulatory peritoneal dialysis. This report describes such a case developing in a woman whose end-stage renal failure was due to adult polycystic kidney disease. Associated predisposing factors were the presence of orthostatic hypoxemia, postural hypotension and extensive atheromatous changes of the abdominal aorta. In keeping with the known difficulty of establishing the diagnosis of mesenteric ischemia, the diagnosis in our patient was also delayed. She was initially thought to suffer from an episode of peritonitis and/or colonic perforation secondary to the performance of a cleansing enema. Only upon showing pneumatosis coli of the right colon on abdominal computerized tomography was the correct diagnosis made. Laparotomy revealed extensive necrosis of the ascending and transverse colon. A total colectomy and ileorectal anastomosis were performed. The patient died on the 17th day following surgery. This case serves to illustrate that mesenteric infarction should be considered in predisposed patients on continuous ambulatory peritoneal dialysis. The presence of peritonitis may mask the underlying pathology and waylay the unwary physician.
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PMID:Nonocclusive mesenteric infarction in continuous ambulatory peritoneal dialysis. 889 66

Over the past 28 years, 39 patients with Moyamoya disease or syndrome defined as spontaneous occlusion of the circle of Willis with extensive basal collateral vessels have been treated by the author in Canada and the USA. All patients presented with clinical or radiologic evidence of hemorrhage (23) or ischemia and infarction (16). A total of 12 patients had associated cerebral aneurysms and seven of these patients with aneurysms presented with subarachnoid hemorrhage. The patients ages ranged from 5 to 47 years. Of these 58% were female. The patients racial origin included North American Indian, Innuit, East Indian/Pakistani, Japanese, Chinese, Filipino, Korean, Malayasian, Hispanic, African American and Caucasian. Familial clustering was seen in North American Indian, Innuit and Caucasian patients. Associated disorders (tuberculosis, pharyngitis, thalassemia, fibromuscular hyperplasia, polycystic kidney, sickle cell trait and hypertension) were common in these patients, as was the use of tobacco, alcohol and in the adult females, oral contraceptives. It may be concluded from this series that the etiology of Moyamoya disease or syndrome is probably multifactorial, but that some racial and familial groups are more susceptible. Furthermore, in that the clinical and angiographic features are identical, the separation between Moyamoya disease and syndrome may not be helpful in understanding the etiology and pathophysiology of this disorder.
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PMID:Risk factors of moyamoya disease in Canada and the USA. 940 4

The cDNA coding for the transcriptional repressor protein Kid-1 was cloned in a screen for zinc finger proteins, which are regulated during renal development and after renal ischemia. Kid-1 mRNA levels increase in the course of postnatal renal development and decrease after acute renal injury caused by ischemia or administration of folic acid. We have raised a monoclonal anti-Kid-1 antibody and demonstrate that the Kid-1 protein is strongly expressed in the proximal tubule of the adult rat kidney. During nephron development, the Kid-1 protein appears after the S-shaped body stage concomitantly with the brush-border enzyme alkaline phosphatase. In two animal models of polycystic kidney disease, the expression of Kid-1 is downregulated. The loss of expression of Kid-1 in cyst wall cells correlates with the loss of alkaline phosphatase histochemical staining. Kid-1 mRNA levels are also reduced in rodent renal cell carcinomas, another condition characterized by epithelial cell dedifferentiation and increased proliferation. We propose that Kid-1 plays an important role during the differentiation of the proximal tubule.
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PMID:Kid-1 expression is high in differentiated renal proximal tubule cells and suppressed in cyst epithelia. 984 10

Epithelial cells mediate the unidirectional movement of selective compounds from one biological compartment to another. This is accomplished by having biochemically, structurally, and functionally distinctive apical and basolateral surface membrane domains separated by the cells' junctional complex. Derangement of this highly ordered situation can result in cell injury, dysfunction, and even death. For renal epithelial cells, both ischemia and polycystic kidney disease are known to result in a loss of surface membrane polarity. In both disease processes, this in turn plays an important role in cell and organ dysfunction.
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PMID:Renal epithelial polarity in health and disease. 1022 7

Renal infiltration with macrophages and monocytes is a well-recognized feature of not only immune, but also nonimmune kidney disease. This review focuses on the investigations that have shown accumulation of immunocompetent cells in experimental models of acute and chronic ischemia, protein overload, hypercholesterolemia, renal ablation, obstructive uropathy, polycystic kidney disease, diabetes, aging, murine hypertension, and nephrotoxicity. We examine the mechanisms of infiltration of immunocompetent cells and their participation in the self-perpetuating cycle of activation of the angiotensin system, generation of reactive oxygen species, and further recruitment of monocytes and lymphocytes. We also discuss the possibility of antigen-dependent and antigen-independent mechanisms of immune cell activation in these animal models. Finally, we review the recent studies in which suppression of cellular immunity with mycophenolate mofetil has proven beneficial in attenuating or preventing the progression of renal functional and histologic damage in experimental conditions of nonimmune nature.
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PMID:Role of immunocompetent cells in nonimmune renal diseases. 1131 33


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