BACKGROUND: The most frequent genetic disease of the kidneys occurring in 1 of 1000 inhabitants is autosomal-dominant polycystic kidney disease (ADPKD). Growing renal cysts compress the kidney resulting in damage to parenchyma and functional disorders. Around 10% of these patients are dialyzed due to terminal renal insufficiency. With the advent of laparoscopic techniques, the idea of laparoscopic excision of cysts seemed a tempting alternative to nephrectomy. We assessed the preliminary results of laparoscopic treatment of polycystic kidneys compared with open nephrectomy for patients with ADPKD. MATERIALS AND METHODS: Thirty ADPKD patients were treated between 2000 and 2004. Eleven procedures in five men and six women of mean age 51 years included laparoscopic cyst excisions. In the remaining 19 patients (six men and 13 women) of mean age 54 years, nephrectomy was done. Indications for surgery included pain due to compression by large cysts and cyst contamination. Patients after nephrectomy were prepared for renal transplantation when necessary. RESULTS: Laparoscopic polycyst removal produced better effects than nephrectomy. Mean operative time was significantly shorter (86 minutes for cyst removal vs 108 minutes for nephrectomy; P < .05). Postoperative pain measured with the VAS scale was reduced in patients after laparoscopy. Hospital stay was shorter (5 vs 9 days), as well as time to recovery. Other benefits of laparoscopic cyst removal included maintained urination in the patient and no need for erythropoietin substitution, as well as reduced risk of cyst contamination. When eligible for renal transplantation, patients after laparoscopic polycyst removal have smaller kidneys that do not interfere with the graft and the risk of infection during immunosuppression seems lower. CONCLUSION: Although larger series of patients are required in patients with ADPKD, laparoscopic polycyst removal seemed superior to early nephrectomy.

Female↗

PubMedDate not supplied

Hypoxanthine as a graft ischemia marker stimulates catalase activity in the renal vein during reperfusion in humans.

BACKGROUND: The impairment of organ function derived from ischemia-reperfusion injury is still an important problem in solid organ transplantation. Cell alterations induced by ischemia prime the tissue for subsequent damage occurring during the reperfusion phase. Purine nucleotides and oxypurines are products of adenine nucleotide degradation. Reperfusion and reoxygenation are characterized by great production of reactive oxygen species and free radicals. On the contrary, superoxide dismutase, catalase, glutathione, and glutathione peroxidase are involved in protecting against free radicals. The aim of the study was to examine the correlation between concentrations of ischemia markers (hypoxanthine or inosine) and the activity of erythrocyte superoxide dismutase, catalase, or glutathione peroxidase. PATIENTS AND METHODS: The study included 40 renal transplant recipients. Before anastomosis of the kidney vessels with the recipient's iliac vessels, a "0" blood sample was taken from the iliac vein. Then, after anastomosis, the renal vein of the graft was cannulated and blood samples I, II, and III were obtained. The reperfusion of the transplanted kidney was measured with a thermovision camera ThermaCAM SC500. RESULTS: The plasma concentrations of hypoxanthine and inosine increased in statistically significant fashion immediately after total tissue reperfusion (P < .0001). Catalase activity at 4 minutes after total tissue reperfusion correlated positively with hypoxanthine concentrations immediately after total tissue reperfusion (Rs = +0.49), 2 minutes after total tissue reperfusion (Rs = +0.47), and 4 minutes after total tissue reperfusion (Rs = +0.46). There were no statistically significant correlations between hypoxanthine or inosine concentrations or superoxide dismutase or glutathione peroxidase activities. CONCLUSIONS: The results of the present study suggest that catalase activity may correlate with the concentration of hypoxanthine in the graft renal vein and other mediators of oxidative stress.

Adult↗

PubMedDate not supplied

Impact of presence of HBs antigen and anti-hepatitis C virus and anti-cytomegalovirus antibodies on transplanted kidney survival.

INTRODUCTION: Infections are one of the most common complications after organ transplantation. Viral infections such as hepatitis type B (HBV) and C (HCV) or cytomegalovirus (CMV) infections are among the most serious ones. A high frequency of HBV and HCV infections has been recognized in kidney recipients. Viral infections play a special role in graft recipients because of clinical symptoms influencing graft function and recipient survival. Immunosuppressive treatment to decrease immunological reactions after organ transplantation may increase the risk of viral infections. The aim of this study was to evaluate the impact of the presence of HBs antigen and HCV and CMV antibodies on patient and graft survivals. MATERIAL AND METHODS: Two hundred one enrolled kidney transplantation patients (96 women and 105 men) were treated with the same immunosuppressive regimen. Age, sex, and viral state (HBs antigen, anti-HCV and anti-CMV antibodies) were evaluated in every patient. Statistical analysis was performed with the Gompertz model, Kaplan-Meier curves and Cox proportional hazard tests. RESULTS: The presence of HBs antigen was detected in 161 patients (20.4%), HCV antibodies in 61 recipients (30.3%); and CMV antibodies in 12 patients (5.9%). Eighty-seven recipients (43.4%) were seronegative. Average recipient age was 38.5 years. CONCLUSION: Time of graft function was independent of the presence of HBs antigen or HCV or CMV antibodies.

Adult↗

PubMedDate not supplied

Early acid-base balance disorders during kidney transplantation.

INTRODUCTION: Reperfusion is a crucial moment in kidney transplantation. Resumption of blood flow is associated with many metabolic changes, which result from the kidney's initial condition and preservation. These biochemical alterations including the acid-base balance are the part of ischemia-reperfusion injury. The study's purpose was to examine acid-base balance during the first 30 minutes after reperfusion of the transplanted kidney. MATERIALS AND METHODS: The 30 recipients (13 men, 17 women) averaged ages of 46 +/- 14 years. Measurements performed nine times (at 0, 1, 3, 5, 10, 15, 20, 25, and 30 minutes after unclamping renal vessels) included: gas analysis, expiratory Pco(2), tidal volume, and respiratory rate. The evaluation of the temporary acid-base balance was performed on the basis of common parameters: pH, Pco(2), [HCO(3)(-)], and base excess (BE). The patients were under general anesthesia with stable external conditions of O(2) saturation, heart rate, blood pressure, and temperature. Blood samples were analyzed using Corning 278 and 248 blood gas analyzer; vital parameters were recorded using Ohmeda 5250 RGM and Dräger Sulla 909V/Julian apparatus. RESULTS: The analysis showed increasing metabolic acidosis with coexisting increase in blood Pco(2), changes that were most intense in the first minute of reperfusion. Decreasing mean pH index did not exceed physiologic limits, but the final mean values of [HCO(3)(-)] and BE were in most of cases below the limit. Increased expiratory air Pco(2) was most intense in the first 3 minutes reaching a maximum at about 15 minutes. CONCLUSIONS: The beginning of reperfusion was the cause of increasing metabolic acidosis, which was partially compensated by blood buffers. Simultaneous increase in expiratory Pco(2), corresponding to the dynamics of acidosis, indicated the existence of respiratory compensation. Sudden increase in acidosis parameters may be the result of lactate accumulation during kidney ischemia. The decreased [HCO(3)(-)] may indicate postreperfusion kidney injury, which must be the subject of further research.

Acid-Base Equilibrium↗

PubMedDate not supplied

Histopathological and histochemical studies of the skin of guinea pigs after long-term exposure to nitrogen dioxide.

Male guinea pigs were exposed to nitrogen dioxide (2 mg/m3) during 180 days (8 hours a day). Long-term exposure induced thickening of the corneal layer of the epidermis as well as inflammatory infiltrations in the proper skin. The following enzymes were estimated histochemically in skin samples of experimental and control animals: succinic dehydrogenase, NADH2-tetrazolium reductase, lactate dehydrogenase; alkaline phosphatase, acid phosphatase and adenosine triphosphatase. Chronic exposrue stimulated a decrease of NADH2-tetrazolium reductase in the epidermis and connective tissue components of proper skin and marked positive reaction of lactate dehydrogenase in epidermal cells and hair follicles. Increase of a diffuse reaction on adenosine triphosphatase in smooth muscles of the skin was found also in exposed animals.

Acid Phosphatase↗

PubMedDate not supplied

The influence of age and some inducers on UDP-glucuronyltransferase activity.

UDP-glucuronyltransferase (UDP-GT) activity was examined in male Wistar rats aged 0.5, 1, 2, 4, 8, 12, 20, and 28 months. The rats were treated with phenobarbital (75 mg/kg, 72 and 48 h before death), beta-naphthoflavone or dexamethasone (40 mg/kg and 20 mg/kg, respectively, for three days before death). Prior to decapitation the rats were fasted for 12 h. Hepatic microsomes were prepared according to the method of Dallner. UDP-GT activity was determined by the method of Burchell and Weatherill. p-Nitrophenol was used as an aglucone. UDP-GT activity decreased rapidly in the control rats aged from two weeks to four months. In the older control rats the activity tended to increase. Two-week-old rats treated with phenobarbital showed a slightly increased UDP-GT activity. In the older animals (up to one year) UDP-GT activity increased to 150% of the control value and stayed at this level in the remaining age groups. beta-Naphthoflavone was a more potent inducer of UDP-GT than phenobarbital. The activity of beta-naphthoflavone-induced UDP-GT was low in the youngest rats. It was about 180% in two-month-old rats and reached 260% of the control value in eight-month-old rats. Although the activity decreased in the older rats, it still exceeded 200%. Dexamethasone did not affect UDP-GT activity. Only in two-week-old and two-month-old rats did we observe a slight increase in the activity of UDP-GT.

Aging↗

PubMedDate not supplied

Effect of enflurane on selected neuropeptides and marker enzymes in rabbit brain.

The aim of this study was to evaluate the effect of 5-, 15-, and 60-min enflurane anesthesia on the levels of Met-enkephalin, Leu-enkephalin and neuropeptide Y in discrete areas of the rabbit brain. We also evaluated the effect of enflurane anesthesia on energetic, transport and catabolic processes by measuring the activities of succinate dehydrogenase, magnesium-dependent adenosine triphosphatase and acid phosphatase in the rabbit striatum and hypothalamus. Induction of anesthesia (5 min) decreased Met-enkephalin levels in the hypothalamus and striatum, and increased them in the hippocampus and mesencephalon. Induction of anesthesia increased Leu-enkephalin levels in all brain areas studied, except for the striatum, and increased neuropeptide Y content in the hippocampus. 15- and 60-min enflurane anesthesia increased Met-enkephalin content in the hypothalamus and hippocampus. After 15- and 60-min anesthesia, and after cessation of anesthesia, Leu-enkephalin levels were increased in the hypothalamus and mesencephalon, and were decreased in the striatum and hippocampus. In the striatum, neuropeptide Y content was significantly decreased during anesthesia and after cessation of anesthesia. Histochemical analysis revealed that enflurane enhanced ATP production, catabolic processes, and the rates of exchange and transport of energetic substrates in the striatum and hypothalamus. In conclusion, enflurane affects the levels of Met, Leu-enkephalins and NPY in a manner depending on the duration of anesthesia and the brain structure. Compared with isoflurane , which was studied in our previous study enflurane produces stronger alterations in the activities of enzymatic marker in the rabbit brain. This suggests that enflurane may be less safe than isoflurane.

Acid Phosphatase↗

PubMedDate not supplied

Neoplastic lesions of the human liver in relation to the activity of the cytochrome P-450 dependent monooxygenase system.

We studied the activity of Mixed function oxidase (MFO) in human livers affected by cancer. We determined the content of cytochrome P-450 and b5, as well as the activity of their corresponding reductases, according to generally accepted methods. Liver fragments corresponding with a) healthy tissue, b) tissue at the cancer border and, c) cancerous tissue were collected during surgery from patients with liver cancer. We noted that the developing liver cancer decreased the level of cytochrome P-450, even by a magnitude order. The activity of its corresponding reductase was higher in cancerous than in healthy tissues. Cytochrome b5 behaved in an analogous manner, although the decrease in its content was less significant. NADH-cytochrome b5 reductase activity changes were insignificant.

Adult↗

PubMedDate not supplied

Fractal analysis of placenta mature villi in healthy, smoking and non-smoking women.

Not all the objects created by nature can be described by means of the classical Euclidean geometry rules. New, quickly developing fractal theory can provide another instrument for describing irregular surfaces of e.g. geometric structures and objects whose development results from growth, differentiation and degeneration processes. In the present study we decided to perform fractal analysis of mature, terminal villi of placenta taken from smoking and non-smoking women, during the third trimester of pregnancy. The aim of this study was to find another morphometric parameter, independent of subjective factors, which would provide new information about the studied structure. Placentas were taken from healthy women, untreated primiparas, who did not undergo any hormonal treatment, aged 18 to 27. The material was divided into: control group--placentas from non-smoking women, and two experimental groups--placentas from non-smoking up to 30 cigarettes daily and placentas from women smoking up to 30 cigarettes daily and placentas from women smoking over 30 cigarettes daily. Fractal dimension was determined by three methods: box counting, dilation and mass scaling method. Taking under consideration the results obtained in the present study it seems that fractal dimension, objectively and independently of many factors, allows to perform mathematical estimation of the parameter which is the terminal villi occurrence density within placenta. Among the applied fractal analysis methods, used for placenta terminal villi density grade estimation, the most useful seems to be the box counting method, whereas for estimating villi surface complication--the ratio--mass scaling method. Comparing obtained fractal dimension results, we have found that they increase together with the amount of cigarettes smoked during pregnancy.

Adolescent↗

PubMedDate not supplied

Antitumor effect of electrochemical therapy on transplantable mouse cancers.

The aim of our study was to assess the antitumor effect of electrochemical therapy (ECT) in the mice bearing advanced transplantable tumours. Mouse mammary cancer 16/C (group 1) and fibrosarcoma F69-3 (group 2) were transplanted subcutaneously (s.c.) into the C3H or BALB/c mice, respectively. Twenty animals in each group bearing measurable s.c. tumours were randomly divided into two subgroups (experimental and control). Two electrodes were inserted into tumours and low level direct current (6-7 V, 5-21 mA) was passed. The animals were observed and tumors were measured twice a week. The animals were sacrificed and autopsied when the tumor diameter reached 2.0 cm. Two animals of each group (experimental and control) were sacrificed for histopathological tumor examination on the 1st and 6th day after ECT. A significant inhibition of tumor growth in mice subjected to ECT was observed, both in those with s.c. growing mammary cancer and with fibrosarcoma. This inhibition was associated with marked prolongation of survival time of ECT-treated mice. It appeared that the mice with mammary cancers were more susceptible to ECT therapy than those with growing s.c. fibrosarcoma. The histopathological studies of tumor specimens from ECT-treated mice showed extensive foci of necrosis with shrinkage of cell nuclei deprived of chromatin. In conclusion, the treatment which inhibits the growth of experimental mammary and fibrosarcoma tumors was demonstrated. However, in no mice complete regression of tumours was observed.

Adenocarcinoma↗