[The surgical problem of coralliform nephrolithiasis].
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Biomedical subjects
Publications and source records attributed to A V Morozov.
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Functional tests, using electro-ureterography, ureteral rheography, electromanometry and electromagnetic flowmetry in the presence of diuretic and perfusion load tests, were performed at surgery in dogs. Ureteral rheography is shown to be a valuable method for the assessment of ureteral motility (as evidenced by ureteral volume changes), and have certain advantages over other techniques so that it can be used clinically for preoperative functional assessment of ectatic ureters. Load tests are necessary at functional tests of the upper urinary system in order to assess the pattern of ureteral wall contractility and reserves.
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.
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Content of cholesterol esters was increased 2.3-fold, triglycerides--4.7-fold, phospholipids--1.5-fold in liver tissue of CCl4-treated rats. The increase in the content of cholesterol esters and triglycerides correlated with a decrease in activity of lysosomal cholesterol esterase from liver tissue. After CCl4 intoxication content of free cholesterol was decreased 2.1-fold, free fatty acids--2-fold, phospholipids--2.3-fold, triglycerides--1.75-fold in blood. In aorta an increase in content of cholesterol esters and triglycerides was found to be 2-fold as well as activation of the cytosolic cholesterol esterase was noted. The data obtained suggest that intoxication with CCl4 affected the accumulation of cholesterol esters in the arterial wall.
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Alterations in activity of cholesterol esterases from lysosomal, microsomal and cytoplasmic cell fractions of rat liver tissue were studied under conditions of acute and chronic hypoxia and hyperoxia. Activity of the membrane-bound lysosomal and microsomal cholesterol esterases was decreased but the cytoplasmic enzyme was activated in acute hypoxia and hyperoxia. These data suggest that the enzymes, responsible for alterations in the ratio free cholesterol/cholesterol esters in cells, are dependent on the level of oxygen consumption.
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