Mesangial function and glomerular sclerosis in rats after unilateral nephrectomy

Mesangial function and glomerular sclerosis in rats after unilateral nephrectomy. To investigate the possible relationship between disturbance of mesangial function and segmental localization of glomerular sclerosis, five uninephrectomized male Wistar rats and five sham-operated controls received colloidal carbon intravenously. At 4 months 8.4 ± 2.5% of the glomeruli of the nephrectomized rats showed focal sclerosis. Glomeruli of nephrectomized rats contained significantly more carbon than glomeruli of controls. Glomeruli with focal sclerosis contained significantly more carbon than normal glomeruli in the same kidneys with a preferential tracer localization within the lesions. In another experiment carbon injections were given before surgery. At 4 months 12.6 ± 4.1% of the glomeruli of the nephrectomized rats showed focal sclerosis, an incidence not significantly different from that of the first experiment. Glomerular carbon content was equal in experimental and control rats and no preferential localization of the tracer within the lesions was found. From these results we conclude that the preferential localization of carbon in the glomerular lesions in rats nephrectomized before injection of carbon is caused by the increased delivery of tracer shortly after injection to those glomerular areas where sclerosis will develop at a later time. The development of focal sclerosis may be related to the local deposition of harmful substances from the circulation.Fonctionnement mésangial et sclérose glomérulaire chez des rats après néphrectomie unilatérale. Afin d'étudier une éventuelle relation entre des anomalies du fonctionnement mésangial et la localisation segmentaire de la sclérose glomérulaire, cinq rats mâles Wistar uninéphrectomisés et cinq contrôles ayant eu un simulacre d'intervention ont reçu du carbone colloïdal par voie intraveineuse. Au bout de 4 mois, 8,4 ± 2,5% des glomérules des rats néphrectomisés avaient une sclérose focale. Les glomérules des rats néphrectomisés contenaient significativement plus de carbone que les glomérules des contrôles. Les glomérules avec une sclérose focale contenaient significativement plus de carbone que les glomérules normaux des mêmes reins, avec une localisation préférentielle du traceur dans les lésions. Dans une autre expérience des injections de carbone ont été faites avant la chirurgie. Au bout de 4 mois, 12,6 ± 4,1% des glomérules des rats néphrectomisés avaient une sclérose focale, cette incidence n'étant pas significativement différente de celle observée au cours de la première expérience. Le contenu en carbone des glomérules était identique chez les rats expérimentaux et contrôles, et il n'a pas été trouvé de localisation préférentielle du traceur dans les lésions. De ces résultats, nous concluons que la localisation préférentielle du carbone dans les lésions glomérulaires de rats néphrectomisés avant une injection de carbone est dûe à une augmentation de l'afflux du traceur peu de temps après l'injection dans les aires glomérulaires où la sclérose se développera ultérieurement. Le développement d'une sclérose focale pourrait être relié au dépôt localisé de substances délétères provenant de la circulation

Surgical pathologic factors that predict recurrence in stage IB and IIA cervical carcinoma patients with negative pelvic lymph nodes

The purpose of this analysis was to identify pathologic risk factors for recurrence and patterns of recurrence in patients with International Federation of Gynecology and Obstetrics Stage IB and IIA cervical carcinoma and negative pelvic lymph nodes after radical hysterectomy. During the period 1982-1991, 271 clinically staged patients with Stage IB or IIA cervical carcinoma underwent a Wertheim-Okabayashi radical hysterectomy with pelvic lymph node dissection. The study group was composed of 196 lymph node negative patients. Pathology slides were reviewed and multivariate analysis performed to identify independent prognostic factors. The recurrence rate in the study group was 7.7%. In multivariate analysis, the following factors were identified as independent risk factors for recurrence: adenocarcinoma (P = 0.003), depth of invasion as a fraction of tumor penetration of the cervical stroma (P = 0.01), and an extensive stromal inflammatory cell infiltrate (P = 0.04). Based on these factors, the following risk groups were identified: a low risk group (N = 140, 5-year disease free interval [DFI] = 97%) and a high risk group (N = 55, 5-year DFI = 81%). An evaluation of the recurrence patterns for these patients showed a predominance of pelvic recurrences. This study showed that among patients with Stage IB and IIA cervical carcinoma and negative pelvic lymph nodes, a subset with a significant risk for recurrence could be identified. Because the majority of recurrences in the lymph node negative group were pelvic recurrences, the value of adjuvant radiotherapy as a treatment for selected lymph node negative patients should be evaluated in a prospective stud