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)

Unilateral ureterosigmoidostomy (U.S.S.) was performed on 15 rabbits and then the animals were sacrificed after 3, 8 and 15 months. The gross appearance of the kidney and radiological investigations revealed enlargement of the pelvis and of the ureter on the operated side although the anastomosis was patent in all cases. In rabbits sacrificed 8 months after U.S.S. an adenomatous polyp was present at the site of anastomosis. Histological examination of the affected kidney showed pyelonephritis secondary to obstruction and immunopathological studies revealed in some rabbits glomerular and tubular deposition of immunoglobulins and complement. The contralateral kidney was always normal. Biochemical investigations showed only a moderate increase in blood urea nitrogen and plasma creatinine values.
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PMID:Renal lesions after unilateral ureterosigmoidostomy in the rabbit: preliminary results. 725 27

Chronic renal infection (Chronic bacterial pyelonephritis) is a cause of tubulo-interstitial nephropathy (nephritis); TIN. The disorder causes end-stage renal failure in about 2% of the patients who are treated by dialysis. However, Chronic bacterial pyelonephritis is a relatively benign condition that seldom leads to renal function loss. The affected kidney shows non-specific histological pictures similar to that seen with other diseases producing TIN. Clinical symptoms are of ten vague. Obstructive uropathy (eg, stones, benign prostatic hyperplasia) is frequently present. The affected kidney, which is almost unilateral, shows atrophy and scarring of variable degree. Significant pyuria and bacteriuria may or may not be found. Depending on the stage of the disease, the serum creatinine and blood urea nitrogen may be normal or elevated. Contributing obstructive uropathy should be corrected. The patients must be followed closely, urinary tract infection must be controlled and complications (eg, hypertension, azotemia) must be identified promptly and treated adequately.
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PMID:[Interstitial nephropathy due to chronic bacterial pyelonephritis]. 756 35

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

Proteus mirabilis urease catalyzes the hydrolysis of urea, initiating the formation of urinary stones. The enzyme is critical for kidney colonization and the development of acute pyelonephritis. Urease is induced by urea and is not controlled by the nitrogen regulatory system (ntr) or catabolite repression. Purified whole-cell RNA from induced and uninduced cultures of P. mirabilis and Escherichia coli harboring cloned urease sequences was probed with a 4.2-kb BglI fragment from within the urease operon. Autoradiographs of slot blots demonstrated 4.2- and 5.8-fold increases, respectively, in urease-specific RNA upon induction with urea. Structural and accessory genes necessary for urease activity, ureD, A, B, C, E, and F, were previously cloned and sequenced (B. D. Jones and H. L. T. Mobley, J. Bacteriol. 171:6414-6422, 1989). A 1.2-kb EcoRV-BamHI restriction fragment upstream of these sequences confers inducibility upon the operon in trans. Nucleotide sequencing of this fragment revealed a single open reading frame of 882 nucleotides, designated ureR, which is transcribed in the direction opposite that of the urease structural and accessory genes and encodes a 293-amino-acid polypeptide predicted to be 33,415 Da in size. Autoradiographs of sodium dodecyl sulfate-polyacrylamide gels of [35S]methionine-labeled polypeptides obtained by in vitro transcription-translation of the PCR fragments carrying only ureR yielded a single band with an apparent molecular size of 32 kDa. Fragments carrying an in-frame deletion within ureR synthesized a truncated product. The predicted UreR amino acid sequence contains a potential helix-turn-helix motif and an associated AraC family signature and is similar to that predicted for a number of DNA-binding proteins, including E. coli proteins that regulate acid phosphatase synthesis (AppY), porin synthesis (EnvY), and rhamnose utilization (RhaR). These data suggest that UreR governs the inducibility of P. mirabilis urease.
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PMID:Proteus mirabilis urease: transcriptional regulation by UreR. 767 44

In this study, the relationship between leukotrienes, peritubular cell infiltration with polymorphonuclear cells (PMNs) and renal tubular damage was investigated in a rat model of acute ascending pyelonephritis. Infection was induced by the injection of 10(5) CFU of Escherichia coli into the bladder and occlusion of the left ureter for 24 h. Treatment of infected animals was started 24 h after the induction of pyelonephritis with either hydrocortisone (25 mg/kg of body weight per day), the leukotriene inhibitor L-651,392 (10 mg/kg/day), or the vehicle of L-651,392 and was maintained for 5 days. At the end of treatment, the animals were killed, serum was collected, and both kidneys were removed for colony counts and histopathology. Renal function was evaluated by the measurement of blood urea nitrogen levels and creatinine clearance. The numbers of PMNs and mononuclear cells (MNs) in the cortex and medulla were recorded for all groups on plastic sections done from the left kidney. Infection alone (vehicle of L-651,392) resulted in intensive interstitial infiltration and a severe tubular destruction in the cortex. Treatment with hydrocortisone did not prevent PMN migration and tissue damage. By contrast, treatment with L-651,392 resulted in a significant reduction in PMNs (P < 0.001 in comparisons with all other groups) and greater preservation of the tubular structure despite identical bacterial counts than in the group receiving hydrocortisone. We conclude that L-651,392 prevents inflammatory cells from reaching the site of infection and protects the kidney from tubular damage associated with inflammation during pyelonephritis. Inhibitors of leukotrienes should be further investigated for their potential benefit as adjuvants to antibiotherapy in the treatment of pyelonephritis.
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PMID:L-651,392, a potent leukotriene inhibitor, controls inflammatory process in Escherichia coli pyelonephritis. 797 88

Computer-aided urinodiagnosis of renal diseases consists in collection of a series of urinary portions in fixed periods at rest, during exercise and drug loading with assessment in each of these portions of protein, urea nitrogen, creatinine, phosphorus, and potassium. Concentrations of all elements are determined by open auto-analyzers using special programs; protein content is measured by two methods, sulfosalicylic acid test and Biuret method. Two data sets are formed including, respectively, information on protein content obtained by the said methods; these data are processed using special programs to reveal the regularities typical of various renal diseases. The method helps diagnose various morphologic types of glomerulonephritis and renal amyloidosis, chronic pyelonephritis and renal tuberculosis, permits assess the risk of oncological diseases of the kidneys and the type of changes in various parts of the nephron and mechanisms of proteinuria.
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PMID:[Computer-assisted urino-diagnosis of kidney diseases using open-type biochemical analyzers]. 803 51

Although various complications such as electrolyte imbalance and urinary infections are known to be induced, ureterosigmoidostomy may still prove to be useful on selected patients who desire a continent form of internal diversion. At our hospital, we performed nineteen ureterosigmoidostomy operations in the seven years between 1981 and 1987. Herein, we have reviewed the postoperative conditions of electrolytes, renal function and other complications. The patients (17 male, 2 female) were between 43 and 75 years old, the mean being 60.3 years. The primary disease was bladder tumor with histopathological findings of transitional cell carcinoma (17) and squamous cell carcinoma (2). Post-operative fluctuations in electrolyte values of Serum Na and Serum K were within the normal value. Hyperchloremia was initially detected in four cases (21.0%), but these were only slightly above the normal range and a year after the operations the conditions were stabilized. Although blood urea nitrogen had a tendency to elevate one or two years after the operation serum creatinine fluctuated within the normal range. After the operations, we administered 10% sodium potassium citrate solution to all patients to prevent hyperchloremic acidosis. During the observation period, only four out of nineteen cases (21.0%) exhibited pyelonephritis. No other complications were observed. Postoperative excretory urograms revealed slight to medium hydronephrosis two months after the operation in four out of nineteen cases but most of these conditions were normalized within a year. Nine patients died after leaving the hospital; seven due to the recurrence of cancer and two due to pneumonia. The ten remaining patients are enjoying normal lives without the use of any external urinary device.
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PMID:[Clinical evaluation on long-term complications of ureterosigmoidostomy]. 807 55

Although emphysematous pyelonephritis has been recognized for more than a hundred years, the actual etiology is still unknown. Glucose fermentation has been implicated as a mechanism of gas formation. We report a case of emphysematous pyelonephritis in which real-time ultrasonography demonstrated intravascular gas bubbles originating in the involved kidney, and passing into the inferior vena cava and hepatic veins. Gas from the affected kidney was analyzed by chromatography; the result showed hydrogen 10.5%, carbon dioxide 39%, nitrogen 49.6% and oxygen 0.8%. The clinical presentation and the results of gas analysis implicate a critical condition that bacteria proliferated rapidly by mixed acid fermentation of glucose. Additionally, the finding of gas production and transportation could explain the previous hypothesis of gas transport. In this critical situation immediate drainage with medical intervention is indicated to treat this life threatening condition.
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PMID:Gas in hepatic veins: a rare and critical presentation of emphysematous pyelonephritis. 825 88

We measured the platelet distribution width, the mean platelet volume, the volume percentage of platelets, and the platelet-to-large-cell ratio in 15 elderly patients with disseminated intravascular coagulation (DIC). Peripheral venous blood mixed with ehtylenediaminetetraacetic acid was analyzed with a Sysmex E-4000 analyzer. The underlying diseases were sepsis, pneumonia, pyelonephritis, and other inflammatory diseases. The mean duration of survival from the onset of DIC was 16.9 +/- 23.9 days. The distribution of red cell sizes before the onset of DIC did not differ significantly from that in patients without DIC, but fragmentation of erythrocytes on blood films was more common in the early stage of DIC (p < 0.01). Before the onset of DIC, the two groups did not differ significantly in the frequency of giant platelets on blood smears. At the onset of DIC, the platelet distribution width, the mean platelet volume, and the platelet-to-large-cell ratio were significantly higher than in patients without DIC. The concentration of glutamic-oxaloacetic transaminase and those of other serum enzymes did not change significantly, but the serum creatinine concentration and the blood urea nitrogen level increased as the platelet-to-large-cell ratio increased. No significant relation was evident between the levels of serum C-reactive protein and creatinine, between the platelet-to-large-cell ratio and the mean volume of red blood cells, or between the platelet-to-large-cell ratio and the distribution of red cell sizes. These data suggest that studies of platelets are more useful in the diagnosis of DIC at early stages of impaired organ function than are other indicators of inflammation such as the level of C-reactive protein.
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PMID:[Changes in erythrocyte structure and in platelets in elderly patients with disseminated intravascular coagulation]. 899 5

Temporal variations in the renal toxicity of aminoglycosides have been reported for experimental animals as well as for humans. In fact, maximal renal toxicity of aminoglycosides was observed when the drug was given during the rest period, while a lower toxicity was observed when the drug was injected during the activity period. The aim of the present study was to evaluate temporal variations in the effectiveness and renal toxicity of gentamicin in an experimental model of pyelonephritis in rats. The experiments were carried out with female Sprague-Dawley rats (185 to 250 g). They had free access to food and water throughout the study and were maintained on a 14-h light-10-h dark cycle. Animals were divided into four groups corresponding to the respective time of induction of pyelonephritis and treatment: 0700, 1300, 1900, and 0100 h. Pyelonephritis was induced by a direct inoculation of Escherichia coli (10(7) to 10(8) CFU) in the left kidney. Animals were treated for 3 and 7 days with a single daily dose of gentamicin (20 and 40 mg/kg of body weight, respectively) or saline (NaCl, 0.9%) at either 0700, 1300, 1900, or 0100 h. Animals treated at 0100 h for 3 days with gentamicin (20 mg/kg) showed a significantly lower number of bacteria in their kidneys than did all other groups (P < 0.01). After 7 days of treatment, the efficacy, evaluated by the log CFU per gram of tissue and by the percentage of sterilized kidneys, was also higher when gentamicin was administered at 0100 h. The beta-galactosidase and the N-acetyl-beta-D-glucosaminidase activities were significantly higher in urine of rats given gentamicin at 1300 h than in urine of rats treated at another time of day (P < 0.05). Gentamicin injected at 1300 h induced a significantly greater increase of [3H]thymidine incorporation into DNA of renal cortex (P < 0.01), a significantly greater inhibition of sphingomyelinase activity (P < 0.05), and significantly more histopathological lesions than the same dose injected at another time of the day. Creatinine and blood urea nitrogen levels in serum were significantly higher (P < 0.05) and the creatinine clearance was significantly lower (P < 0.05) when gentamicin was injected at 1300 h than when it was injected at another time of day. Our data suggest temporal variations in both the toxicity and the effectiveness of gentamicin, the drug being more effective and less toxic when injected during the activity period of the animals.
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PMID:Effectiveness and toxicity of gentamicin in an experimental model of pyelonephritis: effect of the time of administration. 1022 9


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