Stimulation of Structural and Functional Recovery of the Kidney in Rats with Postischemic Acute Renal Failure of Different Severity by Embryonic Protein-Peptide Complex Therapy.

In male rats, acute renal failure was simulated by clamping the vascular pedicle of the left kidney for 60 or 90 min and right-sided nephrectomy. In the control series, no therapy was performed. In the experimental series, the animals were daily injected subcutaneously with Cellex, a protein-peptide complex (PPC) chromatographically isolated from the brain tissue of pig embryos with a molecular weight of its components from 10 to 250 kDa. PPC was administered 5 times a week (10 injections) in a dose of 0.1 ml/kg (0.1 mg active substance per 1 kg body weight). Ischemia of a single kidney led to the development of acute renal failure, more severe after 90-min ischemia. PPC therapy reduced the severity of functional disorders mainly at the early stages (3 and 7 days) with normalization of blood concentrations of urea and creatinine, creatinine clearance, tubular reabsorption of sodium and calcium, including the cases with 90-min ischemia, which did not occur in the control series. PPC therapy also contributed to hypertrophy of many glomeruli, prevented the development of glomerulosclerosis, and reduced damage to the epithelium of the renal tubules. At the same time, neither pronounced lymphohistiocytic infiltration, nor focal nephrosclerosis typical of control series were observed.

Role of oxidative stress and mitochondria in onset of urinary bladder dysfunction under acute urine retention.

Acute urine retention is a frequent complication in patients with benign hyperplasia of the prostate gland. According to studies made on experimental animals and people, it is accompanied by the deterioration of the bladder blood supply. This study attempts to explore the relationship of intramural blood flow, production of reactive oxygen species, and functional state of the bladder detrusor in modeling of acute urine retention in rats, as well as the impact of mitochondria-targeted antioxidants (which are supposed to alleviate the effects of oxidative stress induced by experimental ischemia) on these parameters. The study showed beneficial effects of mitochondria-targeted antioxidant SkQR1 in preventing damage of the bladder caused by acute urinary retention, which suggests the therapeutic use of this type of compounds for the treatment of ischemic abnormalities of the urinary bladder.

[Food additive urisan in combined treatment of urolithiasis].

Thirty three urolithiasis patients (13 males, 18 females aged 29-77 years, 2 children, duration of the disease 1-17 years) received food additive urisan in combined treatment of urolithiasis. Blood and urine biochemistry was studied by 11 parameters to evaluate renal function and lithogenesis before and after intake of urisan. Standard treatment was combined with intake of 2 capsules (1100 mg) of urisan twice a day at meal for 2-3 weeks. The data were processed statistically. It is shown that urisan contributes to intensification of renal filtration function, to reduction of hyperuricemia and urine pH, intensification of uric acid excretion, continuation of inflammation remission, attenuation of proteinurea in urolithiasis patients with exacerbation of chronic pyelonephritis.

Comparative analysis of secretory and reabsorbing activity of ileal and sigmoid mucosa, employed for urinary bladder intestinoplasty.

In experiments on rats we studied reabsorption and secretory activity of the mucosa in isolated segments of the ileum and sigmoid colon used for urinary bladder intestinoplasty after cystectomy. Ileal mucosa was found to retain high metabolic activity under changed conditions. It reabsorbs urea, creatinine, potassium, sodium, chlorine, phosphorus, calcium, glucose, and uric acid from the urine and secretes magnesium, iron, and proteins into the urine. Sigmoid mucosa appeared to be less active in terms of reabsorption of the studied urine metabolites, but more actively secreted calcium and magnesium into urine and additionally secreted sodium. It was accompanied by an increase in blood concentrations of urea, creatinine, glucose, phosphorus, magnesium (only for sigmoid colon) and development of hypoproteinemia. These findings are important for investigation and prevention of metabolic complications after urinary bladder intestinoplasty.

Effects of ischemic and hypoxic preconditioning on the state of mitochondria and function of ischemic kidneys.

Laser confocal microscopy showed that fluorescence of tetramethylrhodamine ethyl ether probe specifically accumulating in energized mitochondria significantly decreased in renal tubular epithelium after 40-min thermal ischemia, while fluorescence of dichlorodihydrofluorescein and diaminofluorescein probes in the same structures increased under these conditions, which attests to increased generation of ROS and NO, respectively. These forms were generated predominantly in mitochondria of tubular epitheliocytes. Hypoxic preconditioning (a series of sessions of breathing hypoxic mixture) preserved functional activity of mitochondria and prevented activation of ROS and NO generation. Ischemic preconditioning of the kidney consisting of three preliminary episodes of vascular clamping (5 min with 5 min reperfusion periods) also increased the percentage of functionally active mitochondria and prevented activation of NO synthesis without appreciably modifying ROS production. Both protective methods significantly reduced the severity of postischemic dysfunction of the kidney.

Experimental intravenous cell therapy of acute and chronic renal failure.

The therapeutic effect of intravenous injection of human fetal bone marrow mesenchymal stem cells or summary culture of kidney cells were studied on models of chronic or acute renal failure in outbred albino rats. Both cell types promoted improvement and normalization of the renal function in rats with stable chronic renal insufficiency (2 weeks after kidney cell injection, 1 month after bone marrow mesenchymal stem cell injection). Renal function remained normal or subnormal during the delayed period (3-3.5 months after injection). In rats with latent stage of chronic renal insufficiency, exacerbation was induced by additional 40-min ischemia. All rats receiving intravenous injection of saline died. Improvement of the functional parameters started 2 weeks after injection of kidney cells or bone marrow mesenchymal stem cells, and normalization was observed after 1.1-5 months. During the delayed period (after 3-4 months), functional parameters retained at normal or subnormal levels. In experimental series III, all rats with acute renal failure intravenously injected with saline (control) died from uremia on days 2-4. After injection of kidney cells 50% rats survived and renal function in these animals returned to normal after 2 weeks. After injection of bone marrow mesenchymal stem cells 83% rats survived, functional parameters returned to normal after 3 weeks.

[Application of cell technologies for therapy of chronic renal insufficiency (experimental study)].

The experiments on 29 white non-inbred rats with chronic renal failure (CRF) induced by right-side nephrectomy and coagulation of 1/2-2/3 of parenchyma of the left kidney were made to study the trend in renal function after injection (into renal cortex or intravenously) of cultured stem or progenitor cells from human fetuses (total culture of fetal kidney or mesenchymal stem cells of the bone marrow). In control tests with salt solution functional indices reflected persistence of CRF. On day 4 after introduction of the fetal cells into renal parenchyma renal function improved and normalized in 2 weeks. After intravenous injection of fetal cells CRF reduced slowly, especially after injection of medullary mesenchymal cells with normalization in 1 month. 2.5-3.5 months after the injection test parameters in some rats deteriorated but remained close to normal values. Glomerular filtration after injection of stem and progenitor cells recovered better while canalicular sodium reabsorption underwent normalization but was followed by deterioration.

Functional aftereffects of intraparenchymatous injection of human fetal stem and progenitor cells to rats with chronic and acute renal failure.

Chronic renal insufficiency was modeled in rats by unilateral nephrectomy and electrocoagulation of both poles of the remaining kidney; acute renal failure was induced by 90-min clamping of the vascular pedicle of the only kidney. Injection of unfractionated culture of human fetal kidney cells or bone marrow mesenchymal stem cells into damaged kidney restored its function in rats with chronic renal insufficiency (observation period up to 2 months). After 2.5 months a relapse of chronic renal insufficiency was observed in 1 of 3 rats receiving human fetal kidney cells and in 1 of 2 animals receiving bone marrow mesenchymal stem cell culture. Injection of bone marrow mesenchymal stem cell culture to rats with acute renal failure improved recovery of renal function and prevented the death from uremia, while injection of total culture of human fetal kidney cells had virtually no effect on the course of acute renal failure.

[The role of phytotherapy in pre- and postoperative period in patients with urolithiasis].

Effects of a biologically active food additive Prolit (PT Industry Djamu Borobudur, Indonesia) on the urinary system and metabolic status of patients with urolithiasis were studied. Total urinalysis, biochemical blood and urine tests by 12 indices, ultrasonic investigation of the kidneys, excretory and plain urography were made in 30 patients aged 23 to 70 years (7 females, 23 males). Prolit was given in a dose 1125 mg three times a day for 1-6 months. Prolit decreased hypercalciuria and urinary pH. A trend was observed to lowering of the degree of leukocyturia, hyperuricemia, hyperuria and hyperoxaluria. Urolithiasis recurrences were absent in 10 cases of 12 (83%), in 18 of 20 patients (90%) concrements did not increase in size. Prolit had no side effects.

[Change in indicators of metabolism and kidney function in intact rats after parenteral administration of sodium hypochlorite]. / Izmenenie pokazatelei metabolizma i funktii pochek u intaktnykh krys posle parenteral'nogo vvedeniia gipokhlorita natriia.

The changes of kidney metabolism, function and enzymuria activity of nephron epithelium cells after 4 days of parenteral administration of sodium hypochlorite 0.02% and 0.06% solutions were investigated in the experiments on 15 intact non-inbred rats of 200-280 g body weight. It was revealed that sodium hypochlorite induced metabolic damage to the kidney similar to ischemic one. The 0.02 and 0.06% solutions of sodium hypochlorite administered parenterally produced no negative effect on renal function. There was no significant rise of enzymuria activity in experimental groups compared to the controls. Moreover, enzymuria of four from six nephron epithelium cell enzymes decreased significantly to day 5 of the experiment. Metabolic damage and enzymuria activity changes were more pronounced in rats given parenteral 0.06% solution of sodium hypochlorite.

[Increase in structural-functional tolerance of kidney to ischemia upon parenteral administration of sodium hypochlorite in the pre-ischemic period]. / Povyshenie strukturo-funktsional'noi tolerantnosti pochek k ishemii pri parenteral'nom vvedenii gipokhlorita natriia v predyshemicheskom periode.

The opportunity of raising kidney structural and functional tolerance to ischemia with parenteral injections of 0.06% solution of sodium hypochlorite for 4 days in preischemia period was studied in experiment on 22 non-inbred rats of 200-280 g body weight. 90 minute ischemia was created by ligating the left and right kidney arteries, veins, ureters. Morphological and functional kidney data, enzymuria activity of nephron epithelium cells were registered, 80 and 33% of the rats survived 7 days after ischemia in the study and control groups, respectively. The control animals showed deterioration of the tubules function, high enzymuria. Thus, it is possible to raise kidney tolerance to ischemia by preischemic parenteral injection of sodium hypochlorite solution.

[Role of biochemical methods in follow-up and treatment of patients with urolithiasis]. / Rol' biokhimicheskikh metodov v dinamicheskom nabliudenii i lechenii bol'nykh mochekamennoi bolezn'iu.

4-6-year follow-up using different tests covered 15 patients with urolithiasis and 11 control subjects aged 25 to 66 years. All the patients underwent 1 to 5 sessions of extracorporeal lithotripsy and one patient underwent open surgery. Clinical and biochemical findings on the groups were compared to the evidence of Litos test. Initiation of antirecurrence therapy should be based on the information gained with different methods, primarily, biochemical. Follow-up of the patients including biochemical control over their metabolic condition must be conducted for at least 5 years.

[Effects of sodium hypochlorite on the course of recovery of structural elements and functions of the kidneys in postischemic period]. / Vliianie gipokhlorita natriia na dinamiku vosstanovleniia strukturnykh élementov v funktsional'nykh sposobnostei pochek v postishemicheskom periode.

Kidney morphological structure, function and enzymuria were studied in experiment on 22 non-inbred rats of 200-280 g body weight with 90 min kidney ligature ischemia on day 3 and 7. In experimental group (11 rats) 1 ml 0.06% solution of sodium hypochlorite (SH) was injected intraperitoneally daily after kidney ischemic damage. 11 rats of the control group received 1 ml 0.89% SH solution in daily intraperitoneal injections. Morphological changes in renal structure, functional capacity of the kidneys, enzymuria on experimental day 3 and 7 were studied. It was revealed that SH injected in acute ischemic phase aggravated kidney cell damage. However, SH induced kidney reparative reaction on day 3. In the control group this reaction was registered only on day 7. It is suggested that SH may be an effective prophylactic modality against ischemic renal damage.

[Sodium hypochlorite in the treatment of bacteremic circulatory shock]. / Gipokhlorit natriia v lechenii infektsionno-toksicheskogo sosudistogo shoka.

17 patients with massive urinary infection and bacteriemic circulatory shock received a combined intensive treatment including indirect electrochemical blood oxidation (IEBO) with 0.06% solution of sodium hypochlorite (SHC). SHC intravenous infusions resulted in stabilization of arterial pressure within 24 hours. IEBO in the treatment of incipient bacteriemic shock improves prognosis.

[Transurethral rotoresection - a new method of benign prostatic hyperplasia treatment]. / Transuretral'naia rotorezektsiia v lechenii dobrokachestvennoi giperplazii predstatel'noi zhelezy.

Karl Storz company (Germany) offers a novel endoscopic technology in the treatment of benign prostatic hyperplasia (BPH) i.e. rotoresection which combined mechanic and electrosurgical methods of removal of the hyperplastic tissue. The operation is performed with application of a special rotoresectoscope connected with a rotor electrode which, in its turn, is connected with mechanical rotor generator making it to rotate and with powerful electrogenerator (radiotome). The hyperplastic tissue is removed both mechanically (by high-frequency rotation of the rotor tip) and due to electrovaporization with simultaneous coagulation of the underlying tissue layers. Transurethral rotoresection was performed in 40 patients with BPH. Intraoperative and postoperative complications were not observed. Examination at discharge and 1 month after surgery showed a 4-fold decrease in the prostatic symptoms by IPSS scale, residual urine decreased 3-fold, maximal urine flow rate rose 2.5-fold. Transurethral rotoresection combines effective removal of BPH tissue with minimal intraoperative bleeding. It is a good alternative to conventional TUR. For more detailed evaluation further studied are needed.

[The role of dynamic observation in the prevention of recurrences of stone formation]. / Rol' dinamicheskogo nabliudeniia v profilaktike retsidivov kamneobrazovaniia.

26 patients with recurrent and non-recurrent urolithiasis treated surgically or by lithotripsy and 14 patients free of urolithiasis were examined biochemically by 9 metabolic blood and urine parameters and using Litos test proposed by urologists of the Moscow Regional Research Clinical Institute for detecting lithogenesis in the kidneys. The comparison of the findings obtained with biochemical and Litos tests showed that these tests are mutually complementary. Monitoring of urolithiasis patients should be complex, i.e. including biochemical examination for disbolism and urinalysis by means of Litos test.

[Lipid peroxidation and the antioxidant system of patients with urolithiasis after extracorporeal lithotripsy]. / Lipidnaia peroksidatsiia i antioksidantnaia sistema u bol'nykh mochekamennoi bolezn'iu posle distantsionnoi litotripsii.

Activity of superoxide dismutase (SOD) in red cell membranes, levels of malonic dialdehyde (MDA) and dienic conjugates (DC) in blood plasma, red cells and urine were studied in 53 nephrolithiasis patients. A session of extracorporeal shock wave lithotripsy stimulated lipid peroxidation (LPO) in renal parenchyma manifesting with increased DC excretion with urine (an 89% increase). In red cell membranes SOD activity fell by 18%, DMA concentration rose by 16%. A two-week intake of vitamin E in a dose 100 mg/day elevated plasma alpha-tocopherol, diminished plasma MDA by 55% and prevented LPO activation in red cell membranes and renal parenchyma.

[The use of new technologies in the endoscopic electrosurgery of benign prostatic hyperplasia of large dimensions]. / Primenenie novykh tekhnologii v éndoskopicheskoi élektrokhirurgii dobrokachestvennoi giperplazii predstatel'noi zhelezy bol'shikh razmerov.

The technique of electrovaporization, a novel low-traumatic method, has been practiced in the Research Institute of Urology (Moscow) for the treatment of benign prostatic hyperplasia (BPH) since 1995. This technique is based on the standard transurethral resection (TUR) being superior in the absence of intraoperative bleeding. Its application, however, is restricted to hyperplasia of small and moderate size. But TUR, in its turn, provides more rapid removal of the tissue. These advantages of the two techniques were combined in the treatment of extensive BPH. Compared to TUR, standard TUR combination with electrovaporization proved much more effective. Progressive techniques in endoscopic surgery comprise also use of novel resection electrodes which differ from the previous analogues by thickness, shape and coating. When used in electroresection, such electrodes provide simultaneous removal of the tissue, electrovaporization and coagulation of the underlying tissues. The above technical innovations allowed advance in the quality of endoscopic interventions, widening indications for endoscopic electrosurgical management of large-size BPH and decreasing the incidence of relevant complications.

[The dynamic level of beta 2-microglobulin, the basic lipid peroxidation indices and middle molecules in the blood and urine in patients with acute calculous pyelonephritis against a background of endovascular helium-neon laser therapy]. / Dinamika urovnia beta 2-mikroglobulina, osnovnykh pokazatelei perekisnogo okislennia lipidov, srednikh molekul v krovi i moche u bol'nykh ostrym kal'kuleznym pielonefritom na fone éndovaskuliarnoi gelii-neonovoi lazernoi terapii.

The authors present the effect of intravenous He-Ne laser therapy on the changes in beta 2-microglobulin, lipid peroxidation, middle-size molecules in the blood and urine of patients with acute calculous pyelonephritis. Endovascular He-Ne laser therapy was found an effective treatment of acute calculous pyelonephritis. The authors propose to combine hemosorption with endovascular He-Ne laser radiation.