Journal of Clinical Nephrology and Renal Care is an international, open access, peer reviewed journal that publishes wide variety of clinical information in all the interdisciplinary aspects of Nephrology. The main objective of the journal is to set a forum for publication, education, and exchange of opinions, and to promote research and publications globally. The Journal provides a podium for all clinicians, surgeons and health professionals to contribute their findings and help raise awareness among community in various aspects of renal care. We aim to publish highest quality clinical content via open access platform providing the readers at no cost, immediate and unlimited access.
Journal of Clinical Nephrology and Renal Care is an open journal, accelerates research updates in various aspects such as discovery and innovation in Pediatric Nephrology, Basic Nephrology, Clinical Nephrology, Dialysis, Renal Anatomy, Physiology, Pathophysiology, functioning, Development and Histology, Glomerular/Tubulointerstitial Disease, Diuretic Pharmacology, Acute and Chronic Kidney Injury, Kidney Failure, Urinary Tract Infections, Tumors, Nephrolithiasis, etc. The journal accepts manuscript formats such as Original Article, Reviews, Mini Reviews, Short Communications, Case Reports, Clinical Image, Perspectives/Opinions, Letters, Short Note and Commentaries. All articles published in the journal are subject to a rigorous peer review process. It encourages authors to publish their work in detail to disseminate the updated research findings.
Articles Search by Keyword | Journal title | Author name | DOI
Open Access DOI:10.23937/2572-3286.1510043
Rui Hong Chen, Fen Song, Yu Gan, Ting Ting Li, Lin Ye, Wei Jing Liu and Hua-Feng Liu
Article Type: Review Article | First Published: May 29, 2019
Transforming growth factor beta1 (TGF-β1) is regarded as the important factor in many fibrotic kidney diseases. Autophagy is a vital mechanism which maintains intracellular homeostasis in eukaryotic cells and involves in various renal physiologic and pathological processes. Current studies indicate that autophagy in renal tubular epithelial cells serves as a renoprotective mechanism which modulates the course of diverse kidney disease....
Open Access DOI:10.23937/2572-3286.1510042
Mohamed A Sheta, MD, Axita Patel, OMS and John R Ross, MD
Article Type: CASE REPORT | First Published: February 23, 2019
Fifty years after the creation of the first arteriovenous access, little is known about the deleterious cardiac effects of this pathological circuit. Understanding the pathophysiology of Access Based Cardiac Disease (ABCD) is critical, given the fact that cardiac abnormalities are the leading cause of morbidity and mortality in end stage kidney disease patients on dialysis. However, this has been a challenge, as many of hemodialysis patients have preexisting cardiac disease, they invariably have...
Open Access DOI:10.23937/2572-3286.1510041
Tchuenkam W Landry, Njoumemi Z, Halle MP and Ashuntantang Gloria
Article Type: RESEARCH ARTICLE | First Published: February 22, 2019
Acute kidney injury (AKI) is a medical emergency. It refers to a heterogeneous disorder characterized by an abrupt and usually reversible decrease in kidney function, resulting in the retention of nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes. Its incidence is on the rise in both developed and developing countries, with the condition resulting in high morbi-mortality and economic burden. To determine the average total cost in the management of acute...
Open Access DOI:10.23937/2572-3286.1510040
Huma Hasnain, Nawal Afif and Susanne B Nicholas
Article Type: Case Report | First Published: December 20, 2018
Renal artery dissections (RADs) are lesions that disrupt vessels that primarily occur in patients with a known history of hypertension and caused by stenosis or enlargement typically due to underlying connective tissue disorders. However, RADs may occur spontaneously from trauma and no previous history of hypertension. Here, we report a rare case of bilateral isolated spontaneous RADs that characteristically occurs in healthy males. A 52-year-old...
Open Access DOI:10.23937/2572-3286.1510039
Ena Gupta, Ravi Sunderkrishnan, Nimrita Sidhu, Maria P Martinez Cantarin, Michael Baram and Bharat Awsare
Article Type: Original Research | First Published: August 27, 2018
Many studies have shown the association between acute kidney injury (AKI) and morbidity and mortality in the Intensive Care Unit (ICU). Traditional measures of AKI, such as serum creatinine and urine output, fail to show dynamic changes in renal function. A feasibility study was performed to evaluate the Nephrocheck test system which comprises of two biomarkers (Insulin-like growth factor binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2)) to screen for patients at ...
Open Access DOI:10.23937/2572-3286.1510038
Shafira Mohamad Sha
Article Type: Review Article | First Published: July 04, 2018
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by a multitude of autoantibody production. Lupus nephritis (LN) is one of its most severe manifestations and its treatment is well established with the usage of immunosuppressions. However the use of these immunosuppressions at high doses are fraught with adverse effects including infections, subfertility and even malignancy....
Open Access DOI:10.23937/2572-3286.1510037
S Chand, J Hazeldine, SW Smith and R Borrows
Article Type: Research Article | First Published: June 25, 2018
Renal disease is a major global public health issue. Renal interstitial fibrosis is the characteristic histopathological finding in all progressive renal disease. Caveolin-1 is the essential structural protein for lipid rafts called caveolae that are ubiquitously distributed among fibroblasts, endothelial and epithelial cells. Caveolin-1 acts as an intracellular signalling pathway chaperone in fibrotic disease....
Open Access DOI:10.23937/2572-3286.1510036
Kelly YP, Wallis L, Patil A, Murray S, Kant S, Kaballo M5, Casserly L, Doyle B, Dorman T, O'Kelly P and Conlon PJ
Article Type: Research Article | First Published: June 09, 2018
Alport syndrome is an inherited renal disease, first described in 1927, which is characterized by haematuria, renal failure, hearing loss, lenticonus, retinal flecks, a lamellated glomerular basement membrane and mutations in the COL4A5 or COL4A3/COL4A4 genes leading to abnormal Type IV collagen composition. The prevalence of the disease is estimated at 1 in 50,000 live births....
Open Access DOI:10.23937/2572-3286.1510035
Bruna S Lourenco, Marcos A Nascimento, Vicente N Siqueira, Sergio A Draibe, Marco T Mello, Sergio Tufik, Maria EF Canziani and Elisa MS Higa
Article Type: Research Article | First Published: May 06, 2018
Chronic kidney disease is a public health problem that causes severe complications to the patient. The major damage is the loss of muscle mass, with a consequent reduction in the functional capacity that is associated with hypertension and increased oxidative stress. This study aimed to evaluate the effect of intra-dialysis resistance training on the hemodynamic parameters, oxidative stress and quality of life in patients with chronic kidney dise...
Open Access DOI:10.23937/2572-3286.1510034
Chaudhry Adeel Ebad, Alan Gaffney and Peter J Conlon
Article Type: Case Report | First Published: January 31, 2018
We report affective utilization of continuous veno-venous hemofiltration for removal of phenobarbital in a patient who took twice amount of fatal dose and was hemodynamically stable. Historically treatment includes supportive care, activated charcoal and urinary alkalinisation along with the application of extracorporeal treatments such as charcoal haem perfusion or hemodialysis and continuous veno-venous hemodiafiltration are affective treatment...
Open Access DOI:10.23937/2572-3286.1510033
Narisa Futrakul and Prasit Futrakul
Article Type: Communication | First Published: November 25, 2017
A non-communicable disease comprising various vascular diseases namely renal microvascular disease, cerebrovascular disease, and coronary vascular disease, has been a threatening public health problem today. The failure of preventive strategy is due to the lack of understanding the nature of the origin of vascular disease....
Open Access DOI:10.23937/2572-3286.1510032
Aysun Aybal Kutlugun, Canan Yildiz and Fatma Ayerden Ebinc
Article Type: Original Article | First Published: October 19, 2017
Hyperkalemia is an important life-threatening electrolyte disorder and one of the most important complications of Chronic Kidney Disease (CKD). Decreased Potassium (K) excretion due to decreased glomerular filtration rate and reduced tubular secretion due to tubulointerstitial dysfunction lead to abnormal K balance and hyperkalaemia in CKD....
Open Access DOI:10.23937/2572-3286.1510031
Grishma Desai, Ted Walton and John J Doran
Article Type: Research Article | First Published: September 28, 2017
Dialysis patients may experience anemia due to functional iron deficiency, which occurs in the presence of sufficient iron stores but not enough circulating iron to provide Erythropoiesis-Stimulating Agents (ESAs) the ability to increase hematopoiesis....
Open Access DOI:10.23937/2572-3286.1510030
Sarinya Boongird, Supawadee Suppadungsuk, Sarassawan Kananuraks and Arkom Nongnuch
Article Type: Review Article | First Published: September 08, 2017
Sepsis has long been recognized as the most common cause of Acute Kidney Injury (AKI), present in approximately 11-40% of patients who are admitted to intensive care units....
Open Access DOI:10.23937/2572-3286.1510029
Gustavo Orellana, Pedro Zambrano, Alejandro Sepúlveda, Ines Araneda, Jorge Rodriguez and Arnoldo Quezada
Article Type: Research Article | First Published: September 02, 2017
Patients with End-Stage Renal Disease (ESRD) on Peritoneal Dialysis (PD) experience high morbidity and mortality due to Cardiovascular (CV) disease. In pediatric patients, CV problems include Left Ventricular (LV) abnormalities, hypertension, and arrhythmias....
Open Access DOI:10.23937/2572-3286.1510028
Xihui Liu, Xiaoyan Zuo, Xueyuan Heng, Zita Abreu, Todd Penner, Lashmi Venkatraghavan and Joanne M Bargman
Article Type: Research Article | First Published: September 01, 2017
Laparoscopy is an effective method of implantation for Peritoneal Dialysis (PD) catheters. However, in many centers around the world, Peritoneal Dialysis Catheter (PDC) insertions are done using an open surgical method, associated with greater surgical trauma and longer duration of hospitalization....
Open Access DOI:10.23937/2572-3286.1510027
Eleanor G Seaby, David J Bunyan, Sarah Ennis and Rodney D Gilbert
Article Type: Case Report | First Published: August 31, 2017
Hereditary, isolated Fanconi syndrome has been described a handful of times in the literature, displaying variable Mendelian patterns of inheritance. Some cases segregate as autosomal dominant and may or may not be associated with renal failure, whilst other kindreds show recessive and X-linked recessive inheritance....
Open Access DOI:10.23937/2572-3286.1510026
Fabiola Pansani Maniglia, Edileuza Santana Soares Penido, Naiane Cristina Soares and Sergio Arthur de Oliveira Campos
Article Type: Original Article | First Published: August 30, 2017
Chronic Kidney Disease (CKD) is characterized by the incontrovertible and gradual loss of endocrine, tubular, and glomerular kidney function, which impairs the removal of toxic metabolites from the body....
Open Access DOI:10.23937/2572-3286.1510025
Gerren Hobby, Mohammed Siddiqui, Shree Sharma and Manisha Singh
Article Type: Case Report | First Published: June 05, 2017
Anti-glomerular basement membrane disease is one of the infrequently encountered nephritic disorders, but one which can lead to poor renal and patient survival. Recent reports have noted the occurrence of anti-GBM disease with atypical histological features on kidney biopsy....
Open Access DOI:10.23937/2572-3286.1510024
Jose Luis Merino, Yésika Amézquita, Maria Ovidia López-Oliva, María Concepción Prados, Pilar Fidalgo and Vicente Paraíso
Article Type: Case Report | First Published: April 17, 2017
The development of vasculitis in renal replacement therapy is rare due to the immunological condition of these patients. Its diagnosis is often complex and invasive tests are usually required. A multidisciplinary approach is mandatory and a broad study (including lung biopsy) is necessary for its diagnosis which is crucial to support the necessity of immunosuppressive therapy in this kind of patients. ...
Open Access DOI:10.23937/2572-3286.1510023
Awad Magbri and Harshit Seth
Article Type: Case Report | First Published: April 13, 2017
The case is of 23-year-old Caucasian male who fell from 30 feet height in a suicidal attempt. He presented to the hospital with fever, generalized macula-papular rash, and malaise. He was discharged initially to LTAC for continued recovery. After 3 weeks in the LTAC he developed pinhole infection of his hip that was reported methicillin resistant staphylococcal infection (MRSA) positive and was started on Vancomycin....
Open Access DOI:10.23937/2572-3286.1510022
Donghua Xie, Guy M Nehrenz, Fernando Bianco, Boris Klopukh and Edward Gheiler
Article Type: Review Article | First Published: February 28, 2017
Magnetic resonance urography (MRU) techniques have matured and have become applicable to the diagnosis of more and more diseases in urinary tract. Modern MRU offers not only increased spatial and temporal resolution, but also provides anatomic and functional information on renal perfusion, excretion and drainage. Patients with renal colic are better examined by non-enhanced computed tomography (CT) scanning because it is highly sensitive in detec...
Open Access DOI:10.23937/2572-3286.1510021
CK Liu, F-C Hsu, V Yank, T Church, S Kashaf, S Nayfield, A Newman, DE Weiner, RS Stafford, B Nicklas3, J Milton, KM Beavers, JD Shegog, RA Fielding and LIFE-P Research Group
Article Type: Research Article | First Published: February 14, 2017
Because chronic kidney disease (CKD) is associated with muscle wasting, older adults with CKD are likely to have physical function deficits. Physical activity can improve these deficits, but whether CKD attenuates the benefits is unknown. Our objective was to determine if CKD modified the effect of a physical activity intervention in older adults....
Open Access DOI:10.23937/2572-3286.1510020
Juan F Martin-Lazaro, Sanja Janjanin, Vasu Kulhalli and James Napier
Article Type: Review Article | First Published: February 04, 2017
Several therapies have been proposed for the treatment of Hypertriglyceridaemic Pancreatitis; an uncommon cause (1-4%) of acute pancreatitis in which physio-pathology is unclear. Different combinations of medical drugs have been used to reduce hypertriglyceridaemia. Plasmapheresis is an invasive but effective alternative for severe cases but it is an expensive and not very accessible option in most of the centres....
Open Access DOI:10.23937/2572-3286.1510019
Donghua Xie, Edward Gheiler and Xiangfei He
Article Type: Review Article | First Published: February 03, 2017
Renal artery aneurysm (RAA) is an infrequent entity. Most of them are asymptomatic, but when they present as a rupture a high mortality is associated. Due to the potential risks of rupture and renal dysfunction and some persistent symptoms like hypertension, RAAs must be treated if feasible. Coil embolization or covered stent placement can now be used to treat patients with aneurysms whose size or location would make a surgical approach problemat...
Open Access DOI:10.23937/2572-3286.1510018
Wei-Yen Kong, Wan Zaharatul Ashikin Wan Abdullah, Halim Gafor, Rozita Mohd and Rizna Abdul Cader
Article Type: Case Report | First Published: December 21, 2016
We present here the first reported case of a young boy who developed classic features of HSP, i.e. palpable purpura, arthralgia, abdominal pain with bloody diarrhea and kidney involvement, following a tetanus vaccine. The diagnosis of HSP was confirmed by skin biopsy and also biopsies obtained from esophagogastroduodenoscopy and colonoscopy. He was initially treated with pulsed intravenous methylprednisolone....
Open Access DOI:10.23937/2572-3286.1510017
Sergio Castano-Avila, Javier Maynar-Moliner, Yolanda Poveda-Hernandez, Fernando Fonseca-San Miguel, Alejandro Martin-Lopez, Carlos Perez-Lejonagoitia, Noemi Legaristi-Florez, Ana Aced-Urbano, Elena Uson-Garcia and Alberto Manzano-Ramirez
Article Type: Original Article | First Published: December 14, 2016
Prospective analysis was conducted in critically ill patients with haemodialysis catheters between 25 October 2009 and 7 December 2010. We gathered data on: demographic characteristics, risk factors, extracorporeal therapy, mortality and microbiological results. CRB was detected through quantitative blood and catheter cultures. We assessed differences between aseptic and non-aseptic catheter insertion (p < 0.05)....
Open Access DOI:10.23937/2572-3286.1510016
Milagros Fernandez-Lucas, Fernando Caravaca-Fontan, Antonio Chinchilla, Jose-Luis Teruel, Nuria Rodriguez-Mendiola, Estefania Yerovi, Laura Blanco, Maria Delgado and Fernando Liano
Article Type: Research Article | First Published: December 12, 2016
Regular surveillance and pre-emptive correction of subclinical stenosis have been shown to be useful procedures for reducing the rate of vascular access (VA) failure. Blood flow (Qa) measurement is considered the best procedure for VA surveillance. Qa below 500 ml/min or reductions over 25% from preceding Qa measurements are predictors of VA thrombosis....
Open Access DOI:10.23937/2572-3286.1510015
Osama A Khamis, Salama S Abdellatif, Mostafa A Alsawasany, Abdellah H ELSadek, Amin M Hegazy, Khaled M Dessouky and Ahmed M Fahmy
Article Type: Original Article | First Published: October 19, 2016
The kidney is involved in the regulation of thyroid hormones metabolism. Numerous abnormalities of thyroid hormones in end-stage kidney disease (ESKD) have been described. The aim of our study was to estimate the prevalence of thyroid dysfunction and its relation to Echocardiologic abnormalities in patients with end stage kidney disease....
Open Access DOI:10.23937/2572-3286.1510014
Agnes Masengu, Melanie Wolfenden, Alexander P Maxwell and Jennifer B Hanko
Article Type: Research Article | First Published: October 12, 2016
Personality traits have been associated with job performance. Previous studies have explored nephrologist preferences regarding optimal renal replacement therapy (RRT) outcomes in patients with end-stage renal disease. The role of physician personality traits and patient outcomes has not been investigated. A pilot study was carried out at a single centre to investigate this....
Open Access DOI:10.23937/2572-3286.1510013
Houda Aboujamous, Ted Walton and John J Doran
Article Type: Research Article | First Published: September 15, 2016
The objective of this study was to quantify the change in serum potassium level after intravenous or oral potassium administration. Secondary objectives include investigating the possible influence of concurrent medications, renal function, and Body Mass Index (BMI)....
Open Access DOI:10.23937/2572-3286.1510012
Nicole Lioufas, Jonathan Ling, Juli Jaw, Mathew Mathew, Matthew Jose and Richard Yu
Article Type: Case Series | First Published: August 31, 2016
Pre-eclampsia is the most common medical complication of pregnancy affecting 3-5% of pregnancies worldwide. Traditional teaching has generally maintained that the natural history of Pre-eclampsia is one of resolution of renal pathology and other clinical features- some days to weeks after delivery of the placenta. Renal injury is mediated by both endothelial and podocyte injury in pre-eclampsia. In some women however, the renal injury does not re...
Open Access DOI:10.23937/2572-3286.1510011
Paul J Hutchison, Yusra Cheema, Hala Yamout, Kathy Johnson Neely and Cybele Ghossein
Article Type: Research Article | First Published: June 27, 2016
Background:Acute kidney injury (AKI) carries a high mortality among patients treated in the intensive care unit (ICU). Continuous renal replacement therapy (CRRT) is used to treat complications of AKI, but it is often initiated in patients who have little hope of surviving. Objective:The authors sought to teach nephrology and pulmonary fellows how to utilize a time-limited trial strategy when discussing CRRT. ...
Open Access DOI:10.23937/2572-3286.1510010
Elizabeth Liang, Mayra Rodriguez, Melissa Mueller, Matthew K Abramowitz and Michele H Mokrzycki
Article Type: Review Article | First Published: May 20, 2016
Background: We aimed to determine outcomes associated with a heparin-free hemodialysis (H-HD) protocol in hospitalized patients. Methods: A retrospective study comparing 2 intra-dialytic heparin protocols: H + HD (routine heparin prime/bolus dosing) and H-HD (saline prime, heparin avoidance). HD circuit patency, need for intra-dialytic interventions and patient bleeding events were the outcomes....
Open Access DOI:10.23937/2572-3286.1510009
Rizawati RI, Shamila K, Shafira MS and Ruslinda M
Article Type: Case Report | First Published: May 20, 2016
Guillain-Barre syndrome (GBS) is also known as an acute inflammatory demyelinating polyneuropathy (AIDP). It is an immune-mediated polyneuropathy commonly post-infectious in origin that presents with ascending weakness, loss of sensation and deep tendon reflexes resulting from demyelination of peripheral nerve. Drug-induced neuropathy has been describing before and remains a rare clinical entity. Development GBS after an episode of infections suc...
Open Access DOI:10.23937/2572-3286.1510008
Anna Dorothea Hock
Article Type: Review Article | First Published: May 14, 2016
Vitamin D3-insufficiency/ deficiency is a common condition arising from prevalent indoor activities and use of sunscreens with high protection factor. Lacking sunlight is frequent in patients suffering from chronic fatigue syndrome (CFS), fibromyalgia (FMS), and myalgic encephalopathy (ME) probably because of fatigue-related reduction of outdoor activity, high premorbid engagement in professional or caring activities, and preceding stressful life...
Open Access DOI:10.23937/2572-3286.1510007
Leonilde Amado, Veronica Poveda, Ricardo Ferreira, Nuno Ferreira, Vasco Miranda Laetitia Teixeira, Constanca Paul, Alice Santos-Silva and Elisio Costa
Article Type: Original Article | First Published: April 28, 2016
Patients with end-stage renal disease (ESRD) under dialysis showed a higher prevalence of depression, which is independently associated with non-adherence, hospitalization and mortality. We aimed to evaluate the prevalence of depression and associated variables, among ESRD late-life patients under online-haemodiafiltration (OL-HDF)....
Open Access DOI:10.23937/2572-3286.1510006
Salwa Selim Ibrahim Abougalambou, Syed Azhar Syed Sulaiman, Ayman S. Abougalambou and Mohamed Azmi Hassali
Article Type: Research Article | First Published: March 23, 2016
Nephropathy is a major cause of illness and death of patients with type 2 diabetes mellitus (DM), Diabetic nephropathy has become the leading cause of end-stage renal disease; kidney failure that requires a lifetime of dialysis. It develops in about 20-40% of Type 2 Diabetes patients....
Open Access DOI:10.23937/2572-3286.1510005
Anna Ryden, Matthew Wolfe and Mona L Martin
Article Type: Research Article | First Published: February 01, 2016
End-stage renal disease treated with hemodialysis (ESRD-HD) is associated with poor outcomes for patients and can substantially reduce health-related quality of life (HRQL). Alongside drug development for this patient group, there is a need for a better understanding of patients' perceptions of their condition, their symptoms and the impact ESRD-HD has on their lives. Here, we report data from qualitative, semi-structured, concept-elicitation int...
Open Access DOI:10.23937/2572-3286.1510004
Gabriela Hernandez-Molina, Joaquin Zuniga, Adriana Torres-Machorro, Lourdes Mena-Hernandez, Antonio Cachafeiro, Julio Granados and Marina Rull-Gabayet
Article Type: Research Article | First Published: January 31, 2016
Background: Hyperuricemia is frequent among renal transplant recipients. The role of the HLA system in the susceptibility of hyperuricemia is unknown. Methods: We evaluated the HLA-B and HLA-DRB1 distribution among 160 renal recipients: 132 with hyperuricemia (Group 1) and 28 free of it (Group 2) as well as 381 ethnic-specific Mexican-mestizo population historic controls. The HLA alleles were assessed by PCR-SSP and the HLA allele gene frequencie...
Open Access DOI:10.23937/2572-3286.1510003
Vij Sarah C, Karim Wadih, Luzny Patrik, Myers Jeremy B, Emilio Poggio, Herts Brian and Wood Hadley
Article Type: Research Article | First Published: January 31, 2016
Renal volume-based estimates of glomerular filtration rate (GFR) using computed tomography (CT) in renal donor populations have been described. We hypothesized that the same technology would be especially useful in myelomeningocele (MMC) patients for whom standard methods of GFR assessment are inaccurate....
Open Access DOI:10.23937/2572-3286.1510002
Ibrahim A Qaqish and Mira T Keddis
Article Type: Review Article | First Published: August 22, 2015
The H1N1 influenza A (swine flu) was first recognized in 1918 during the influenza pandemic and was first isolated from humans in 1974. Several reports ofH1N1 influenza A was reported between 1958 and 2005 with mortality rates up to 17%. In 2009 worldwide outbreak of H1N1 influenza A led the world health organization to raise its pandemic alert to its highest level. H1N1 influenza A was found to be associated with significantly higher mortality i...
Open Access DOI:10.23937/2572-3286.1510001
Tripti Kumar, Thomas Fennell and Ping L. Zhang
Article Type: Original Article | First Published: August 17, 2015
After the initial diagnosis of a renal biopsy, direct immunoflorescent (DIF) slides would be ideally kept for later internal and external reviews. Although there is an assumption that rapid reduction in florescent intensity occurs after DIF staining, no renal DIF study has addressed how long DIF slides can be reliably stored for re-examination at room temperature....
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