[Disorders of the rheological properties of the blood and microcirculation in surgical patients].
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Biomedical subjects
Publications and source records attributed to A G Shapkin.
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The authors describe the method of regional continuous infusion into the renal artery of antibacterial cocktails used in 8 patients (cavernous tuberculosis of the kidney in 4 patients, purulent injury of the parenchyma in 4 patients) and the method of superselective embolization of the renal artery branches before the organ-preserving operation performed in 2 patients.
The analysis of results of organ-preserving operations in 46 patients with the retention-inflammatory diseases of the kidneys has shown the complex urologic examination, renal angiography included, to be necessary for choosing the operation volume. It was established that obstruction can be frequently caused by a subsidiary polar-inferior vessel (artery or vein).
Embolization of renal arteries by an autoclot with thrombin was used in 16 patients. Hypernerphroma was diagnosed in 13 patients, pyonephroses--in 2 patients and adrenal tumor--in one patient. In two patients catheterization of the renal artery failed due to atherosclerotic injury of the aorta. Nephrectomy was fulfilled in 14 patients. In two patients the treatment involved only embolization of the renal artery. The important part is played by adequate anesthesia. The authors highly estimate the method and recommend it for wider use in clinics.
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A technique for the surgical treatment of patients with cavernous tuberculosis of the solitary kidney has been developed. An early surgical treatment of tuberculosis of the solitary kidney with the ureteral stricture is proved as well as the advantages of ureteropyelostomy over other ways of elimination of urine.
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Some experimental data concerning the pathogenesis of tuberculous injury to the kidneys have been obtained from a complex study of the microcirculatory blood bed on a model of tuberculosis of the kidneys in 112 rabbits. Clinical investigations and clinico-experimental correlations have provided pathogenetic grounds for a surgical method of the treatment of tuberculosis of the kidneys complicated with strictures or the ureter. The pathogenetic association of the main tuberculous focus in the renal parenchyma with the tuberculous injury to the ureter and perivascular expansion of specific infection has been pointed to. The effectiveness of pathogenetically grounded surgical intervention has been proved in 52 patients followed-up from 1.5 to 7 years.
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The problem of brain ischemia damage treatment stimulates the search for new effective methods, which are studied on various experimental models. Most of such models possess significant disadvantages, producing hypoxia in the whole organism, being poorly controlled, involving serious traumas, and still being far from true pathological mechanisms accompanying the ischemia development. A model of focal brain ischemia in rats, induced by middle cerebral artery intravasal occlusion, is free of these disadvantages.
The neuroprotector properties of cyclopentyladenosine (CPA), an adenosine receptor agonist, were studied on a model of focal brain ischemia in rats (reproducing a clinical pathological process in humans). The model of the focal brain ischemia in rats was induced by intravasal occlusion of left carotid artery, middle cerebral artery, and by bilateral occlusion of both carotid arteries. CPA was introduced by intracerebroventricular injections in a dose of 25 micrograms/kg, 60 min before ischemia induction. The protective effect was judged by comparing the neurological and histopathological disturbances in the control (untreated ischemia) and on the CPA background. CPA injections produced a pronounced neuroprotector effect on the minimum-invasive focal brain ischemia model in rats.