Urologiia i nefrologiia最新文献

Animal experiments demonstrate that gentamycin, kanamycin and carbenicillin affect lipid peroxidation in the kidneys. This can be registered by chemiluminescence of renal and urinary homogenates. This phenomenon was also used in functional examination of the kidneys in 161 neonates treated by antibiotics. The earliest renal dysfunctions due to nephrotoxicity were detected by chemoluminescence induced by ions of bivalent iron. The method is simple and rapid, this making it convenient in neonatal practice for detection of nephropathy before the symptoms presentation.

In cadaveric renal transplantation with simple cold storage, pretransplant evaluation of allograft viability creates an important problem. To assess the degree of ischemic damage and microcirculation of the renal allograft, experiment comparing parameters, like median perfusate flow and median intrarenal resistance, with histological findings was made. Kidney harvesting was performed from three groups of New Zealand rabbits by keeping warm ischemic time zero, thirty, sixty minutes for each group. Following perfusion with Euro-Collins solution and 24 and 48 hours of hypothermic preservation, perfusion was repeated. Perfusion parameters were measured and histopathological examination of the kidneys was made with light microscopy. In arterioles and glomerular, peritubular capillaries, red blood cell trapping was seen. It was also observed that an increase of warm ischemic time aggravates the erythrocyte aggregation and tubular degeneration. Following reperfusion, resistance measured from renal arteries by Protocol Propaq 106 manometer was named as terminal intrarenal resistance. It is noticeable that this simply measured parameter shows correlation with other parameters and histopathological findings.

584 kidney transplantations (208 from cadaveric donors, 376 from living relative donors) were performed in Medical Faculties of the Istambul University in 1986-1997. Thrombosis of the renal artery was observed in 2 patients (0.35%). One of them had diffused arterial atherosclerosis 4 months after the kidney transplantation. In spite of two successful thrombectomies, the patient died 3 months after the last surgical procedure from cerebral thrombosis. The other patient underwent nephrectomy. Hypertension was observed in 63 patients. In 5 of them about 50% stenosis of the anastomotic area was detected by doppler duplex scan and selective angiogram. Transluminal angioplasty was performed in one patient, open surgical correction in one case. Renal vein thrombosis took place in 1 (0.2%) patient. In 2 cases (0.35%) 5 and 12 years after the transplantation aortic aneurysmal dissection was observed.

Selective alpha-1-adrenoblockers are thought promising in current conservative treatment of benign prostatic hyperplasia (BPH). The trial of doxazosin (cardura)--a selective alpha-blocker--included 78 BPH patients with obstructive urination. All the patients received a single daily dose of doxazosin 4-8 mg (mean 5.7 mg). 60 patients on placebo served as control. The comparison of the effects observed in the study vs control group has demonstrated that doxazosin has a favourable effect on BPH: it improved quality of life, relieved obstructive symptoms, reduced amount of residual urine. There is objective urodynamic evidence on decreased infravesical obstruction.

The results of the study of the influence of lysozyme on fertile characteristics of ejaculate obtained from sterile patients are presented. Improvement of functional activity of spermatozoa in vitro due to lysozyme has been determined. The method of the treatment of infertile couples by homologous insemination is proposed.

88 patients with benign prostatic hyperplasia (BPH) were given the inhibitor of 5 alpha-reductase proscar (finasteride, Merck and Co. Inc., USA) for 12-14 months and uroselective blocker of alpha-adrenoreceptors alfuzosin (dalfas, Synthelabo Group, France) for 4-5 months. The patients were examined before the combined treatment and on the treatment month 1, 3, 6 and 12. The proscar plus alfuzosin combination produced a response after 2-3-week treatment due to alpha-blocker Further, the effect was enhanced by the action of inhibitor of 5 alpha-reductase. Combination of alfuzosin with proscar meets three principal requirements demanded of BPH chemotherapy: improves urination, inhibits the growth of adenomatous tissue, diminishes the size of the enlarged prostate.

The action of indirect electrochemical blood oxidation with 0.06% solution of sodium hypochlorite on kidney and urinary inflammation was studied in experiments on 60 non-inbred rat females of 200-250 g body weight. The animals were intravesically infected through the catheter with E. coli and Ps. aeruginosa. 3 days later, after histological verification of acute pyelonephritis, ureteritis, cystitis, the animals were injected intraperitoneally 1.0 and 2.0 ml daily of sodium hypochlorite solution (control animals) or 0.89% solution of sodium chloride. Though no reliable decrease of the bacterial contamination was achieved, histologically, there was a marked reduction in morphological signs of the inflammation in the kidneys, ureter and urinary bladder on the first day after beginning of electrochemical blood oxidation with solution of sodium hypochlorite in experimental groups. In experimental group rats morphological signs of urinary and renal inflammation for both infections disappeared on days 7 and 10, respectively. In the control animals morphological signs of the inflammation remained after 10 days. Moreover, purulent inflammation was registered in the controls infected with Ps. aeruginosa.

As there are still no accurate criteria of assessing middle-lobe prostatic benign hyperplasia contribution through the "valve effect" to development of infravesical obstruction, the authors propose to introduce "miction" transrectal ultrasonic study. This study provides evidence allowing to divide patients with middle-lobe prostatic benign hyperplasia into three groups by the degree of the "valve effect". This enables differential approach to choice of the scope of the operative intervention.

94 children (109 kidneys) with congenital hydronephrosis were treated in 1989-1997. 67 of them underwent 76 plastic operations: Andersen-Hynes operation on the ureteropelvic segment without pelvic resection (n = 53), antevasal pyelopyelo- and ureteropyeloanastomosis (n = 18), ureteropyelolysis (n = 5). Excellent, good and satisfactory results were obtained in 16.5, 50.6 and 30.4% of cases, respectively. The analysis of changes in the renal-cortical index before and after plastic operation with reference to hydronephrosis stage and form, type of the pelvis evidenced that the best treatment outcomes were achieved in children with open hydronephrosis stage II having extrarenal pelvis. Poor outcomes occurred in closed hydronephrosis stage III and intrarenal pelvis. Renal planimetry, as one of highly informative diagnostic techniques, can be used in assessing results obtained in hydronephrosis treatment.