[Are the sequelae predictable for sectional and multiple partial nephrolithotomies of completely intrarenal coral stones? (experimental and clinical research)]. / Predskazuemy li posledstviia sektsionnoi i mnozhestvennykh partsial'nykh nefrolitotomii po povodu polnost'iu vnutripochechnykh korallovidnykh kamnei? (éksperimental'no-klinicheskoe issledovanie).

In the assessment of surgical intervention for fully intrarenal stone casts, different kinds of nephrotomies (sectional or multiple partial ones, those supplementing pyelolithotomy or performed in the kidneys with marked parenchyma) should be compared in terms of functional outcomes, severity and incidence of complications (intraoperative or postoperative bleeding from the violated kidney), postoperative urinary fistulas, aggravated renal failure and postoperative mortality. It is these milestones that have determined the scope of the present study. An experimental assessment of the degree of trauma, associated with sectional nephrolithotomy as well as its functional sequelae was made in dogs after a stone-like structure was simulated and the kidney reached the necessary degree of secretory deficiency. The comparison of pre- and postoperative renographic parameters over different spans of follow-up of animals after sectional nephrolithotomy was made to assess the latter's organ-damaging effect and, in part, functional results of surgery in a kidney with a profound functional deficiency by the time of the operation. A similar methodology was used in clinical patients, subjected to nephrolithotomy (either sectional or multiple partial procedure) for fully intrarenal coral stones. Functional results of nephrolithotomies in animals and in patients are presented in Figs 1-3. For cases where postoperative results were good or satisfactory at 1-2 months, follow-up results are presented in Tables 4-5. Postoperative complications of sectional and partial nephrolithotomies are reflected in Figs. 4-5. The incidence of paranephritis and postoperative mortality are reported in Tables 6-7. Therefore, functional results of sectional nephrolithotomy are indicative of its considerable organ-sparing effect in experimental animals. Functional outcomes of the clinical sectional and multiple partial nephrolithotomies are similar, yet partial nephrolithotomies are more detrimental to the kidney and the upper urinary tract in terms of the pattern and rate of postoperative complications, as compared to sectional nephrolithotomy. As the sequelae of sectional and partial nephrolithotomies are largely unpredictable, indications for surgical removal of intrarenal stereometrically-composite coral stones should be as limited as possible.

[Lipid peroxidation in a kidney tissue homogenate from rats under heat-induced ischemia with and without glucocorticoid protection]. / Perekisnoe okislenie lipidov v gomogenate pochechnoi tkani krys pri teplovoi ishemii bez i s protektsiei gliukokortikoidami.

Lipid peroxidation (LPO) was investigated in cortical layer homogenates from 56 rat kidneys, intact or exposed to a 30-minute heat ischemia performed without any protection or after a preliminary administration of prednisolone alone or in combination with methypred. Prednisolone was administered i.m. in a dose of 30 mg/kg 2 hrs before and the same dosage of methypred a day before the onset of the experiment. Homogenates were studied both for the initial levels of malonic dialdehyde (MDA) and for the MDA formation in the presence of LPO which was activated in the phosphate buffer by pH 6.8 ascorbate (5.10(-4) M) 5, 10, 15, 20, 25 and 30 minutes after the incubation. The results obtained demonstrated that versus the intact kidneys, in the kidneys exposed to a 30-minute treatment with heat ischemia there were increased levels of initial MDA in the renal tissue, a dramatic increment of its formation during the incubation of homogenate with ascorbate. Shifts in the kinetic curves in homogenates from ischemic kidneys were noted as well. A more dramatic rise (versus intact kidneys) in the MDA formation levels in the presence of LPO observed at the initial stage of the incubation was suggestive of an exhaustive effect of heat ischemia on the system of endogenous antioxidants. The dramatic increment of MDA levels was recorded during a 30-minute incubation. Administration of prednisolone alone or in combination with methypred resulted in a significant inhibition of LPO in ischemic renal tissue.(ABSTRACT TRUNCATED AT 250 WORDS)