Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

61 patients suffering from chronic pyelonephritis in the stage of active inflammation associated with either urolithiasis (67.4%) or prostatic adenoma (32.6%) were divided into three groups. Group 1 received conventional antibacterial treatment, group 2 conventional treatment + local laser radiation (LLR), group 3 received combined therapy including intravascular laser irradiation of blood (IVLIB). The treatments efficacy was controlled by urine seeding for microflora and its sensitivity to antibiotics, by immunological supervision. The patients were found to have immunological abnormalities in the form of cellular and humoral immunity suppression, neutrophil phagocytic hypoactivity, elevated levels of medium-molecular peptides nonresponsive to standard antibacterial therapy. Adjuvant use of LLR improved humoral immunity and reduced total urine bacterial count. LLR replacement for IVLIB resulted in a complete regression of immunological shifts and more pronounced reduction of urinary bacterial contamination.
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PMID:[The potentials of local and intravascular laser irradiation for eliminating the immunological disorders in patients with chronic pyelonephritis]. 754 Mar 38

Urease (urea amidohydrolase; EC 3.5.1.5) catalyzes the hydrolysis of urea to yield ammonia and carbamate. The latter compound spontaneously decomposes to yield another molecule of ammonia and carbonic acid. The urease phenotype is widely distributed across the bacterial kingdom, and the gene clusters encoding this enzyme have been cloned from numerous bacterial species. The complete nucleotide sequence, ranging from 5.15 to 6.45 kb, has been determined for five species including Bacillus sp. strain TB-90, Klebsiella aerogenes, Proteus mirabilis, Helicobacter pylori, and Yersinia enterocolitica. Sequences for selected genes have been determined for at least 10 other bacterial species and the jack bean enzyme. Urease synthesis can be nitrogen regulated, urea inducible, or constitutive. The crystal structure of the K. aerogenes enzyme has been determined. When combined with chemical modification studies, biophysical and spectroscopic analyses, site-directed mutagenesis results, and kinetic inhibition experiments, the structure provides important insight into the mechanism of catalysis. Synthesis of active enzyme requires incorporation of both carbon dioxide and nickel ions into the protein. Accessory genes have been shown to be required for activation of urease apoprotein, and roles for the accessory proteins in metallocenter assembly have been proposed. Urease is central to the virulence of P. mirabilis and H. pylori. Urea hydrolysis by P. mirabilis in the urinary tract leads directly to urolithiasis (stone formation) and contributes to the development of acute pyelonephritis. The urease of H. pylori is necessary for colonization of the gastric mucosa in experimental animal models of gastritis and serves as the major antigen and diagnostic marker for gastritis and peptic ulcer disease in humans. In addition, the urease of Y. enterocolitica has been implicated as an arthritogenic factor in the development of infection-induced reactive arthritis. The significant progress in our understanding of the molecular biology of microbial ureases is reviewed.
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PMID:Molecular biology of microbial ureases. 756 14

The causes of bacteriotoxic shock were examined in 33 patients (11 lethal outcomes). It has arisen as a complication of treatment given to 7830 patients for urolithiasis. Aggravation of chronic pyelonephritis, occlusion of the urinary tracts, urogenital mucosal and parenchymal injuries, low resistance to infection contribute to microbacteria and their toxins entering blood with resultant bacteriotoxic shock. Transcutaneous operative interventions, therapeutic and diagnostic procedures also produce high risk of blood infection with gram-negative microflora, especially in violation of asepsis and antisepsis rules. As shown by microflora tests, the dominating bacteria consisted of opportunistic agents which had acquired the resistance to antibacterial drugs. In view of rapid progression of bacteriotoxic shock therapeutic efforts should be concentrated on fast normalization of hemodynamics, recovery of urine passage, introduction of sorption detoxication, prevention of DIC syndrome. The schemes of combined antibiotic treatment adjusted to the kind of infectious agent are suggested.
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PMID:[Bacterial toxic shock as a complication of calculous pyelonephritis]. 787 14

Red blood cells obtained shortly before and after a hemosorption session from 12 patients were studied in scanning electron microscope. The patients suffered from chronic renal failure and purulent intoxication consequent to urolithiasis and purulent pyelonephritis (10 cases), renal arteriosclerosis (1 case) and prostatic cancer (1 case). Before hemosorption number of discocytes measured 50.8%, while that of stomatocytes 37.3%. Spherocytes, echinocytes and knisocytes occurred in larger quantities. After hemosorption diskocytes amounted 67%, echinocytes and acanthocytes levels rose. The changes may be due to normalization of blood biochemistry after the hemosorption, and to sorbent effects on red cells.
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PMID:[The morphological characteristics of the erythrocytes during hemosorption in patients with chronic kidney failure and suppurative intoxication]. 794 Nov 24

The activity of oxidant metabolism was studied in leukocytes from the whole blood of 23 patients diagnosed to have urolithiasis, chronic pyelonephritis in remission. Leukocyte function was evaluated by registration of luminol-dependent chemiluminescence. Barium sulfate microcrystals served leukocyte stimulator. Chemiluminescence was registered by chemiluminometer NPA-02. Diagnostic implication of chemiluminescence and other clinical-laboratory parameters was derived from the equations of multiple linear regression arranged in a model. It is shown possible to significantly assess chronic inflammation activity in renal tissue by whole blood chemiluminescence and ESR. Low functional activity of neutrophils recorded by chemiluminescence may indicate chronicity of renal tissue inflammation.
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PMID:[The determination of the chemiluminescence of stimulated blood leukocytes in assessing the activity of chronic pyelonephritis]. 798 98

The paper describes a number of modifications in the operative procedures, pre-, intra- and postoperative antibacterial treatment introduced to decrease the number and severity of infectious-inflammatory complications of endourological surgery for urolithiasis; presents the results of anti-bacterial prophylaxis of urinary infection aggravation in 29 patients suffering from urolithiasis combined with renal anomalies. Antibacterial treatment was performed with ftorquinolone drug ciprinol (ciprofloxacin hydrochloride) made in Slovenia. 18 patients received ciprinol twice a day at a dose 500 mg 3-5 days before the operation and within 5-7 postoperative days. The other 11 patients received the drug intravenously (100 mg in drops) in parallel with initial anesthesia and during 1-2 postoperative days. It was continued orally within the next 5-6 postoperative days. The analysis of ciprinol pharmacokinetic profile showed its concentrations in the blood and urine to surpass minimal inhibitory concentration for the majority of the isolated microorganisms. Out of 18 patients treated with oral ciprinol, postoperative aggravation of pyelonephritis occurred in 3 (16.7%) versus 8 (40%) cases out of 20 controls. 11 patients on intravenous ciprinol developed no complications. The conclusion is made on high efficacy of preoperative antibacterial preparation and of intraoperative antibacterial therapy continued for some time after the surgery in cases of percutaneous endoscopic surgical interventions for urolithiasis attended by chronic urinary infection. The antibacterial treatment brings about a 2-3-fold decrease in the occurrence of postoperative inflammatory complications.
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PMID:[The prevention of infectious-inflammatory complications in the postoperative period in percutaneous surgical interventions in patients with urolithiasis]. 801 1

Health examination of events in the Evenki Autonomic Region and events in Yakutia using multiprofile questionnaires revealed high incidence of renal diseases: chronic pyelonephritis, chronic cystitis, nephroptosis. The former occurs most frequently, runs in association with nephroptosis and chronic cystitis, affects females more frequently than males. Nephroptosis is attributed to a nomad's life which the natives lead. In spite of high urinary oxalates and urates levels, urolithiasis in the Northerners occurs relatively seldom.
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PMID:[The epidemiology of the most prevalent kidney diseases in the nationalities of the North]. 816 Mar 13

The study aimed at evaluating the proximal tubule function in patients with active metabolic urolithiasis with the assay of beta 2-microglobulin in the urine. The studies involved 30 patients with urolithiasis associated with chronic pyelonephritis and 31 patients with urolithiasis without pyelonephritis. Fifty healthy individuals served as a control group. Serum and urine beta 2-microglobulin concentrations were assayed with radioimmunological technique in all persons. Clearance of this microglobulin and tubular reabsorption were calculated. It was found that beta 2-microglobulin excretion with the urine is significantly higher in patients with metabolically active urolithiasis accompanied by the chronic pyelonephritis. beta 2-microglobulin clearance was significantly higher and tubular reabsorption significantly lower than those in patients without pyelonephritis and in control group. These finding suggest a dysfunction of the proximal tubule in patients with urolithiasis produced by the chronic inflammatory process in the urinary system. Negative correlation between blood serum beta 2-microglobulin levels and creatinine clearance was shown. Therefore, serum beta 2-microglobulin concentrations may be of value in evaluation of the glomerular filtration rate.
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PMID:[Usefulness of determining beta-2-microglobulin in serum and urine in patients with metabolically active kidney calculi and healthy individuals]. 817 Aug 11

Proteus mirabilis, a significant cause of bacteriuria and acute pyelonephritis in humans, produces urease. This high-molecular-weight, multimeric, cytoplasmic enzyme hydrolyzes urea to ammonia and carbon dioxide. To assess the role of urease in colonization, urolithiasis, and acute pyelonephritis in an animal model of ascending urinary tract infection, we compared a uropathogenic strain of P. mirabilis with its isogenic urease-negative mutant, containing an insertion mutation within ureC, the gene encoding the large subunit of the enzyme. Mice challenged transurethrally with the parent strain developed significant bacteriuria and urinary stones. The urease-negative mutant had a 50% infective dose of 2.7 x 10(9) CFU, a value more than 1,000-fold greater than that of the parent strain (2.2 x 10(6) CFU). The urease-positive parent strain reached significantly higher concentrations and persisted significantly longer in the bladder and kidney than did the mutant. Indeed, in the kidney, the parent strain increased in concentration while the mutant concentration fell so that, by 1 week, the parent strain concentration was 10(6) times that of the mutant. Similarly, the urease-positive parent produced significantly more severe renal pathology than the mutant. The initial abnormalities were in and around the pelvis and consisted of acute inflammation and epithelial necrosis. By 1 week, pyelitis was more severe, crystals were seen in the pelvis, and acute pyelonephritis, with acute interstitial inflammation, tubular epithelial cell necrosis, and in some cases abscesses, had developed. By 2 weeks, more animals had renal abscesses and radial bands of fibrosis. We conclude that the urease of P. mirabilis is a critical virulence determinant for colonization, urolithiasis, and severe acute pyelonephritis.
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PMID:Contribution of Proteus mirabilis urease to persistence, urolithiasis, and acute pyelonephritis in a mouse model of ascending urinary tract infection. 851 76

Renal carcinoma and urolithiasis combine rather rarely. Postnephrectomy patients often consult the urologist when the condition is serious because of complications resultant from uroliths in the contralateral kedney. In view of solitary kidney, progressive chronic pyelonephritis, associated chronic renal failure surgical treatment of the condition becomes risky and necessitates individual approach to choice of therapeutic policy and definition of indications to urolithiasis treatment in patients after nephrectomy for renal carcinoma. This includes the decision whether to perform nephrolithiasis before or after nephrectomy and whether to attempt any surgery in the absence of urolithiasis clinical symptoms.
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PMID:[The treatment procedure in patients with a combination of kidney tumor and urolithiasis]. 868 15


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