[Choosing a method of draining the upper urinary tract following percutaneous nephrolithotripsy].

PURPOSE: to compare various methods of upper urinary tract drainage in patients with urolithiasis. PATIENTS AND METHODS: 60 patients were included into a prospective study which ran from March 2013 through December 2014. All patients underwent PCNL with a nephrostomy tract diameter of (28-30 Ch.) at the I.M. Sechenov First Moscow State Medical University urology clinic. Patients were divided into 2 groups. Group 1 30 (patients) underwent nephrostomy after PCNL with nephrostomy tract placement, in group 2 (29 patients) internal drainage was performed. One patient withdrew from the study due to residual stone. Adequacy of urinary tract draining was assessed by operative time and blood loss. A comparative analysis was performed to outline difference in both groups by length of hospital stay, severity of flank pain in early postoperative period and 5 days after the procedure, day of drain removal. RESULTS: the average operative time in group No1 was 104 minutes (+/-17 min.), and 71 minutes (+/- 19 minutes) in group No2 . The average hemoglobin level before surgery in both groups was roughly comparable and amounted to: 141.5g / l (+/-13) in group No1, in group No 2 143.6 g / l (+/-18). At the same time, hemoglobin level in the early postoperative period varied in both groups and was as follows: 121g / l (+/-13) in group No1, and 128g / l (+/-14) in group 2. Evaluation of pain severity by VAS score showed that severity of pain in an early postoperative period was roughly comparable in both groups and amounted to 6.29 and 6.05 points, respectively, but from the second day, and since the activation of the patients, the values of the intensity of pain in both groups became differ. Group No1: - 5.33 (+/-1.5) on day 2, 3.25 (+/-1.8) on day 3, - 2.5 (+/-1.6) on day 5. A more thorough elucidation of the cause of pain showed that in 56 (88%) patients the pain was due to the nephrostomy and pain in the nephrostomy stroke while driving and only 7 (11%) patients complained of a pain in the operated kidney. Group No2: - 3.5 (+/-1.2) on day 2, - 2.9 (+/-1.4) on day 3, 1.22 (+/-0.8) on day 5. CONCLUSION: A detailed and thorough history, taking together with multislice computed tomography and multiplanar 3D modeling allows for better preoperative assessment regarding a size, a number and location of stones, vascular architecture of the kidney. This enebles an experienced endoscopic surgeon to plan an operation, and avoid the possible difficulties associated with lithotripsy and choose a more suitable method of pyelocaliceal system draining after the operation. In turn, tubeless PCNL, with proper intraoperative managamant and careful selection of patients appears to be safe and effective. Drainage of the upper urinary tract with internal drainage reduces intensity of postoperative pain, which improves the quality of life of patients in the postoperative period, and reduces the length of postoperative stay.

Genes encoding bile acid, phospholipid and anion transporters are expressed in a human fetal cardiomyocyte culture.

OBJECTIVES: To establish a human fetal cardiomyocyte culture and to investigate whether the genes that encode transporters that may influence influx or efflux of bile acids are expressed in human fetal cardiomyocytes. DESIGN: Laboratory study. SETTING: Imperial College London. SAMPLE: Six fetal hearts were obtained at the time of termination of pregnancy at 12-13 weeks of gestation and used to generate primary human cardiomyocyte cultures. METHODS: To confirm the presence of cardiomyocytes, the cells were incubated with monoclonal antibodies to sarcomeric alpha-actinin and anticardiac myosin heavy chain. Real-time reverse transcription polymerase chain reaction was used to establish whether transcripts of genes that may influence bile acid transport are present in the culture (NTCP, BSEP, MDR3, FIC1, MRP2, MRP3, OATP-A, OATP-C, OATP-D, OATP-E) and whether taurocholate administration alters messenger RNA (mRNA) expression. MAIN OUTCOME MEASURES: Relative mRNA expression of genes of interest. RESULTS: Real-time polymerase chain reaction demonstrated the presence of mRNA for BSEP, MDR3, FIC1, OATP-C, OATP-D and OATP-E in fetal heart. Four transcripts remained in the cardiomyocyte culture (BSEP, MDR3, FIC1 and OATP-D), and we demonstrated the influence of taurocholate on gene expression. CONCLUSIONS: We have developed an in vitro model of the fetal heart that may be used for studies of the cardiac effect of endobiotics, e.g. bile acids, or of specific agents that may be used to treat the mother or fetus in pregnancy.

Dexamethasone and ursodeoxycholic acid protect against the arrhythmogenic effect of taurocholate in an in vitro study of rat cardiomyocytes.

OBJECTIVE: To establish whether the therapeutic agents ursodeoxycholic acid and dexamethasone protect cardiomyocytes from taurocholate-induced arrhythmias in an in vitro model. DESIGN: Laboratory study. SETTING: Imperial College London, Hammersmith Campus. SAMPLE: Neonatal rat cardiomyocytes. METHODS: Using scanning ion conductance microscopy, we measured the rate, rhythm, amplitude of contraction and calcium dynamics of ventricular myocytes from one to two day old rats. Cells were pre-incubated for 16 hours in dexamethasone (80 or 800 nM) or 0.1 mM ursodeoxycholic acid before adding taurocholate at different concentrations (0.3-4.5 mM). MAIN OUTCOME MEASURES: Changes in rate and amplitude of contraction, calcium dynamics and rhythm. RESULTS: Taurocholate at concentrations of up to 3 mM induces abnormal changes including reductions in rate, amplitude of contraction, abnormal calcium dynamics and dysrhythmias. Although dexamethasone had no immediate protective effect on these changes, pre-incubation with dexamethasone was protective. Ursodeoxycholic acid pre-incubation was protective at taurocholate concentrations up to 1 mM. CONCLUSION: The therapeutic agents dexamethasone and ursodeoxycholic acid appear protective against the arrhythmogenic effect of taurocholate on cardiomyocytes.

Laminin-2/4 from human placenta is a better adhesion agent for primary keratinocytes than laminin-1 from EHS sarcoma.

A comparison of the adhesion of human primary keratinocytes to laminin-1 from murine EHS sarcoma and laminin-2/4 from human placenta was carried out using two methods, cell adhesion to substrates covered with the laminin isoforms, and interaction of keratinocytes from suspension with latex beads coated with the proteins. Laminin-2/4 was considerably more potent as a promoter of attachment of primary human keratinocytes than laminin-1 (and fibronectin), with increased attachment of cells correlating well with the number of latex bead binding sites. Only small cells of diameter of less than 20 microm bound more than 5 beads. Staining of keratinocytes with involucrin antibodies confirmed the existence of an inverse relationship between laminin-2/4-coated bead binding and differentiation.

Urban begging and ethnic nepotism in Russia : An ethological pilot study.

Ethnic nepotism theory predicts that even in times of communal peace altruism is more pronounced within than between ethnic groups. The present study tested the hypothesis that altruism in the form of alms giving would be greater within than between ethnic groups, and greater between more closely related groups than between more distant groups. The three groups chosen for study were ethnic Russians, Moldavians, and Gypsies. Russians are genetically closer to Moldavians than to Gypsies. Observations were made of 128 ethnic Russian, 25 Moldavian, and 25 Gypsy beggars receiving gifts from ethnic Russians in Moscow trains. The Gypsies were mainly girls, contrary to the Russian sample. Multivariate analysis identified three main strategies: active, personified, and appeasing-undirected. Russian strategies were most variable. Gypsies presented strong charity releasers: 84% were children who played music and sang and showed appeasing-undirected behavior. The few adults were highly submissive or friendly. Nevertheless, their success was limited compared with that of ethnic Russians despite the latter's demanding behavior and their being mostly mature or elderly persons. Moldavians received an intermediate amount of charity. The hypothesis was supported.

Matrigel increases the rate of split wound healing and promotes keratinocyte ;take' in deep wounds in rats.

The influence of matrigel, a mixture of the components of thebasement membrane, on the wound healing was studied in a modelof experimental wounds in rats. Matrigel was found to increasethe rate of epithelization of split-thickness wounds. The modelof deep wound was developed in which the host animal could notprovide enough migrating and proliferating keratinocytes tocover the wound area. The model is relevant to severe burns andinjuries in humans. When rat keratinocyte suspension wastransplanted into deep wounds, cell retention in the wound bedwas only observed if matrigel was added together with the cells.Increasing matrigel concentration in the wound was seen toenhance the rate of wound area coverage by the cells. Althoughthe process of healing seemed macroscopically normal, afterhistological screening of the biopsies cell in the wouldappeared as amorphous aggregates and tubules rather thenstratified epidermis.

Role of feeder cells in spreading and cytoskeleton organization of newborn rat keratinocytes.

We studied the effect of feeder cells (fibroblasts) and a mixture of the extracellular matrix components, Matrigel, on spreading and cytoskeleton organization of newborn rat keratinocytes (REK). REK formed lamellipodia on being plated together with feeder cells and on the Matrigel as a substrate whereas the same REK plated alone on a plastic surface formed filopodia. REK lamellipodia formation in co-cultures depended on the fibroblast addition time. Although conditioned medium from fibroblast cultures was not enough to induce lamellipodia, the extracellular matrix left after fibroblast removal was as effective as Matrigel. Our results indicate that lamellipodia formation seems to depend on the factor(s) secreted by fibroblasts and associated with the extracellular matrix.

Long-term survival and production of testosterone by immobilized human embryonic testis fragments.

To study a new approach of graft preparation for transplantation of Leydig cells to correct androgen abnormality we have cultivated immobilized human embryonic testis fragments. The cultures were viable for at least 17 days and continuously produced testosterone. The paraffin sections showed histotypic organization of immobilized tissues, but not of free tissues, with good preservation of cells. This indicates that immobilized testicle fragments can be considered as candidates for transplantation grafts.