Nephromegaly Relates to Hepatocyte Growth Factor Dysregulation in Biliary Atresia

To demonstrate nephromegaly in children with biliary atresia and children with compensatory renal hypertrophy and to examine their plasma hepatocyte growth factor (HGF), transforming growth factor beta1 (TGF-beta 1), and the difference of total kidney volume, 11 children with biliary atresia (age range 5 months to 10 years), 11 with compensatory renal hypertrophy, and 11 age-matched healthy controls were investigated. Kidney volume was measured by renal ultrasonography and plasma HGF and TGF-beta1 levels were studied. To clarify the significance of nephromegaly in biliary atresia, creatinine clearance was also measured in 9 children with biliary atresia and 9 healthy children. The unilateral kidney in biliary atresia and the solitary kidney in compensatory renal hypertrophy had significantly higher kidney volumes compared with those of healthy children (P<0. 001 by analysis of covariance). However, a significant increase in total kidney volume was noted only in children with biliary atresia (P<0.001 by analysis of covariance). Although this was actually associated with increased creatinine clearance (117.3+/-22.0 ml/min per 1. 73 m(2) vs. 98.3+/-13.6 ml/min per 1.73 m(2) in controls, P<0.05), corrected creatinine clearance was not correlated with total kidney volume (r=0.199, P=0.61) in biliary atresia. Plasma HGF levels and HGF/TGF-beta1 ratios were elevated in children with biliary atresia (2,648+/-1,215 pg/ ml and 233.8 +/-139.1 pg/ng vs. 493+/-131 pg/ml and 35.9+/-15.7 pg/ng in compensatory renal hypertrophy and 468+/-194 pg/ml and 24.0+ /-19.6 pg/ng in controls, P<0.001) and had a positive correlation with total kidney volume by multiple regression analysis (P=0.006 and P=0.002, respectively) . These results show that nephromegaly in biliary atresia is associated with increased total kidney volume and a higher glomerular filtration rate , and is positively correlated with plasma HGF and plasma HGF/TGF-beta1 ratio, implying a role of HGF in this situation. However, nephromegaly in compensatory renal hypertrophy may have different mechanisms in terms of normal total kidney volume, transient elevation of plasma HGF followed by normal plasma HGF, and normal plasma HGF/TGF -beta1 ratio. These data also suggest a common mechanism ( HGF) for initial renal hypertrophy (as in compensatory renal growth), with dysregulation of control of this process later in the course (as in biliary atresia). The detailed mechanisms for nephromegaly in these two conditions should be further clarified

Urinary Epidermal Growth Factor Excretion in Children with Chronic Renal Failure

To investigate the excretion of urinary epidermal growth factor (EGF) in children with chronic renal failure (CRF), we have measured the urinary EGF/creatinine ratio (EGF/Cr) and the 24-hour urine EGF concentration in 19 children with CRF, 11 children with kidney disease and normal creatinine clearance, and 12 healthy children. Children with CRF had a significantly lower daily urine EGF concentration as well as urinary EGF/ Cr. In contrast, children with kidney disease and normal renal function had normal daily urine EGF levels and urinary EGF/Cr. Accompanied by no difference in serum EGF between these two groups of patients, these data provide indirect evidence of the kidney as a source of human urinary EGF. There was a positive correlation of urinary EGF /Cr with creatinine clearance in all renal patients (r = 0. 608, n = 30, p < 0.001). A much better correlation was found between daily urine EGF and creatinine clearance (r = 0.855 , n = 30, p < 0.001). Our results implicate that there is a functional relationship between glomerular filtration and urinary EGF excretion, and that the urinary EGF/Cr may be a reliable indicator of urinary EGF excretion in children with CRF

Urinary N-Acetyl-Beta-Glucosaminidase in Children with Acute Renal Failure

This work is a requirement for the Final Course Assignment over the practicum I have been doing for the period corresponding to my practice experience at the Traçat architecture firm. First, I will give a brief introduction putting emphasis on my motivations. Secondly, I believe it is necessary to begin this assignment with an evolutionary review of the Traçat firm from its foundation to the present times from the point of view of its physical as well as functional structure as seen through its organigram. I will also develop the functions of the different departments involved, the services offered, the work environment and the type of clientele. In third place, logically, I will give a description of my experience as a Construction Supervisor at Traçat, discussing the functions I carried out, contrasting the work done in the office with the work done at the construction site and the peculiarities I encountered in the execution of my functions in facultative direction and Project management. I will provide a detailed discussion over the different construction projects where I gained experience during the practicum and the tasks I carried out there under the direction of various technical architects on staff at the firm. Finally, I will give my conclusions where I will discuss the results of a continued reflexion, the daily implications, an analysis which came from the practice, what we will call on-the-spot experience, so necessary for theoretical knowledge to take shape as something more than just potential