Background. According to foreign and domestic authors, a kidney cyst is one of the most common urological diseases and accounts for up to 2050%. Aim. To evaluate the results of various methods of surgical treatment of patients with kidney cysts. Materials and methods. An analysis was made of 124 case histories of patients who underwent inpatient treatment for symptomatic kidney cysts at the urology department of the Regional Clinical Hospital for the period 2016 to 2019. Also, an analysis of 50 case histories of patients who were hospitalized with the same diagnosis on the basis of the urological department of the emergency hospital for the same period. Results. Puncture methods of treatment were used only in patients whose cysts radiologically corresponded to categories I and II according to Bosniak. On the basis of the urological department of the emergency hospital, 50 people were operated on in this way, of which 22 (44%) women and 28 (56%) men. The mean age of the patients was 58.25 years. Punctures of cysts with evacuation of contents without sclerotherapy 3 (6%) cases, and puncture of cysts with sclerotherapy with 96% ethyl alcohol 47 (94%) cases. The average age of patients who underwent surgery in the regional hospital was 56.612 years. According to MSCT, cysts of category I according to Bosniak were diagnosed in 96 patients (77.4%), category II in 11 (8.9%), category IIF in 11 patients (8.9%), category III in 6 (4.8%). Laparoscopic excision of the cyst wall was performed in most cases 109 (88%), laparoscopic nephrectomy was performed in 1 case (0.8%), laparoscopic nephrectomy in 10 (8%) cases, retroperitoneoscopic excision of the cyst wall 1 (0.8%), open intervention by lumbotomy access 3 (2.4%), of which nephrectomy was performed in two patients, one patient underwent kidney resection. Conclusion. Surgical treatment of symptomatic kidney cysts was justified and necessary, as evidenced by the relief of symptoms and verification of cysts suspicious in terms of the likelihood of oncological pathology. Puncture methods of drainage and sclerotherapy are less radical, but justified in patients with high surgical risk. Excision of a cyst or resection of a kidney by laparoscopic access is an effective method of treatment that meets modern safety requirements for treatment.
We have studied CD38, Cx43 expression in rat brain cells after perinatal hypoxic-ischemic injury. We found regulation of CD38 by modulators of metabolism of endogenous retinoic acid or by exogenous retinoic acid and Cx43 by glycirretinoic acid. Possibility to use the data for development of pharmacological method of neuroprotection is discussed.To elicit hypoxic-ischemic perinatal brain injury, 7-day-old perinatal (P7) rats (n = 40) were subjected to right carotid artery ligation followed 1 h of 8% oxygen exposure (Rice J., 1981). Control animals (n = 20) were sham-operated. Biological material (front and occipital brain areas) was taken away in 4, 8, 72 hours, 10 days after the operation for preparing frozen slices. Expression of CD38, Cx43, GFAP, MAP2, modulation of Cx43 activity in astrocytes by 5 M glycirretinoic acid (GRA), modulation of CD38 in vivo by retinoic acid (RA) (20 mg/kg), fluorimetric measurement of CD38 were done.CD38 expression after hypoxic-ischemic brain damage raises 8 h after brain injury following by reducing in P17 to control meanings. The amount of Cx43 + and GFAP + cells increases in acute period of hypoxia, what attracted Cx43 + -astrocytes enhancement in damage area. On postischemic 10th day 80% of Cx43 + -cells and 42% of GFAP + cells are CD38-immunopositive, but amount of MAP2 + cells reduces as well as number of MAP2 + CD38 + neurons. Cx43 inhibitor GRA reduces ADP-ribosyl cyclase activity. RA decreases CD38 expression in astrocytes.Acute period of perinatal hypoxic/ischemic brain injury attends by reactive astrogliosis, change of CD38 and Cx43 expression in astrocytes is marker of neuroglial interactions disturbances after perinatal CNS injury, modulation of which by RA regulators and GRA make a base for new therapeutic neuroprotective strategy at perinatal period.Perinatal hypoxia-ischemia (HI) brain damage remains the major cause of acute mortality in newborns and can cause deep cognitive and motor deficiencies in infants and children. However, there is not an efficient mean to avoid the consequences of this severe impairment. As preconditioning (PC) strengthens endogenous cellular defences, triggering preconditioning is a promising strategy to develop new and safe therapies. Low doses of carbon monoxide (CO) prevent cell death in primary cultures of astrocytes and neurons. Moreover, this endogenous molecule can induce a PC cellular state, which involves reactive oxygen species (ROS) as signalling intermediaries. Thus, the objective of the present work was to apply CO as an agent able to decrease tissue injury via PC-induction and cell death prevention in a rat model of perinatal brain HI. Rat pups were exposed to 250 ppm for 1 h (37 • C) at day 4, 5 and 6 after birth and hypoxia-ischemia was induced at P7, according to adaptations in the Vannucci model (left carotid artery ligation and 75 min of 8% O 2 ). The brains were collected 24 h and 1 week after HI for cell death and tissue protection assessment by histological analysis. Whereas apoptotic bodies were abundant in the hipp...
Introduction. Obstruction of the pyeloureteral junction is the most common anomaly of the upper urinary tract. Irrespective of the causes, narrowing of the ureteropelvic junction leads to abnormal urine outflux, increased intrarenal pressure, gradual sclerosis of renal parenchyma, loss of kidney function. In some cases, obstruction of the ureteropelvic junction can be accompanied by dystopic kidney, nephroptosis, abnormal location of the main and accessory renal vessels which requires correction of the standard surgical treatment.The study objective is to evaluate the effectiveness of combination of laparoscopic pyeloplasty with kidney transposition and nephropexy in obstruction of the pyeloureteral junction of a dystopic kidney.Materials and methods. Medical records of 8 patients who underwent surgery in the Kracnoyarsk Regional Clinical Hospital between 2017 and 2021 were analyzed. Obstruction of the pyeloureteral junction was confirmed clinically by ultrasound of the kidneys, excretory retrograde pyelography, contrast-enhanced spiral computed tomography.Results. In all of the 8 patients, lumbar dystopia of the affected kidney was diagnosed, in 25 % pathology was accompanied by nephroptosis, in 50 % of cases by abnormal location of the main and accessory renal vessels. All patients underwent laparoscopic plastic surgery of the pyeloureteral junction per Anderson–Hynes with antegrade ureter stenting, kidney transposition, nephropexy. Mean operative time was 190 ± 39 min, no intraoperative blood loss was observed. Ureteral catheter was removed at day (6.3 ± 2.2). Hospital length of stay was 9.3 ± 3.7 days. In 1 patient, postoperative period was complicated by suture breakage in the posterior wall of the pyeloureteral anastomosis which required repeat laparoscopy to correct suture defect. Time of ureteral stent implantation was 34.6 ± 8.5 days. Control examination showed full remission of pain syndrome. Excretory urography showed full outflow of the contrast agent after examination with furosemide in 100 % of cases.Conclusion. Combination of laparoscopic plastic surgery of the pyeloureteral segment with kidney transposition and nephropexy is an effective minimally invasive operation for treatment of ureteropelvic junction stricture of a dystopic kidney.
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