SummaryBackgroundIn a healthy kidney, contractile protein alpha-smooth muscle actin (ASMA) is immunohistochemically strongly expressed only in the blood vessels, while in pathological conditions it can be visualized in glomerular mesangial cells and interstitial myofibroblasts. The aim of this study was to explore the possible correlation between expression of ASMA in glomerulonephritis (GN) and indicators of renal function.Material/MethodsWe analyzed expression of ASMA in percutaneous renal biopsy of 142 adult and pediatric patients with GN and its correlation with blood pressure, serum creatinine, creatinine clearance and 24-hour urine protein at the time of biopsy. Immunoexpression of ASMA was analyzed quantitatively using computer-assisted morphometric analysis. Relative surface of ASMA expression in all glomeruli and interstitium was calculated for each patient.ResultsIn adults and children, greater expression of ASMA in interstitium was associated with higher serum creatinine and reduced creatinine clearance. Conversely, greater ASMA expression in glomeruli was associated with normal or decreased serum creatinine in adults and increased creatinine clearance in children. In children, correlation was found between high blood pressure and ASMA expression in interstitium.ConclusionsWe confirmed that interstitial expression of ASMA is associated with reduced renal function at time of biopsy. The connection of ASMA expression in glomeruli with lower serum creatinine and normal or increased creatinine clearance suggests a favorable role of this phenotypic change in glomerular filtration rate; further investigation is needed.
The authors believe that anxious depression and SPS-plus seen in this patient are the result of the same underlying autoimmune process, together forming a unique syndrome. Anxious and depressive symptoms in SPS can be explained by alterations in GABAergic neurotransmission.
U radu je istraživana povezanost obrambenih mehanizama i drugih parametara ovisnosti (dob, spol, bračni i radni status, vrsta ovisnosti, te duljina i težina ovisnosti). Rezultati istraživanja su pokazali da su dominantni obrambeni mehanizmi kod ovisnika: apatično povlačenje, devaluacija, negacija, potiskivanje, projekcija, projektivna identifikacija i racionalizacija. Rezultati su također pokazali da postoje razlike u svim navedenim ispitivanim elementima. Kod žena se ovisnost razvija znatno rjeđe nego kod muškaraca, ali kada se ovisnost razvije tada ima teži oblik (češće prisutni nezreli obrambeni mehanizmi). Ovisnost o alkoholu i kockanju je više povezana s potiskivanjem, racionalizacijom, negacijom i projekcijom, a ovisnost o drogama i internetu s apatičnim povlačenjem, devaluacijom i projektivnom identifikacijom. Daljnja istraživanja obrambenih mehanizama ovisnika značajno će doprinijeti daljnjem napretku u dijagnostičkim i terapijskim postupcima. / This paper investigates the correlation between defence mechanisms and other parameters of addiction (age, gender, marital and work status, type of addiction, and length and severity of addiction). Research findings have shown thatdominant defence mechanisms in addicts are apathetic withdrawal, devaluation, denial, repression, projection, project identification and rationalization. These results also showed that there are differences in all of the above-mentioned parameters. In women, addiction develops considerably less often than in men, but when addiction develops it has a heavier form (more often, immature defence mechanisms are present). Alcohol and gambling addictions are more associated with repression, rationalization, denial and projection, and addiction to drugs and the internet with apathetic withdrawal, devaluation and projective identification. Further research on defence mechanisms in addicts will significantly contribute to further progress in diagnostic and therapeutic procedures.
U svakodnevnom kliničkom radu s ovisnicima susrećemo se s upadljivim destruktivnim ponašanjem tih pacijenata. To destruktivno ponašanje ima svoju psihodinamsku pozadinu koju smo mi promatrali iz kuta koncepta o nagonu smrti. Ovim radom smo htjeli kratko prikazati navode iz literature o eventualnoj povezanoti ovisničkog ponašanja i nagona smrti te ukazati na eventualnu praktičnu primjenu takve povezanosti. / In our daily clinical work with addictive patients we meet with theirs extreme destructive behavior. This destructive behavior has a psychodynamic background which we considerd from the angle of the deathdrive concept. With this work we wanted to examine the possible connection in the literature and the possible practical implication of the connetion between addictive behavior and death-drive concept.
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