Search results

1

Immunodetection of surfactant proteins in human organ of Corti, Eustachian tube and kidney.

100%

Kankavi O.

Acta Biochimica Polonica

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2003

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vol. 50

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issue 4

1057-1064

EN

The presence of surfactant proteins was investigated in the human organ of Corti, Eustachian tube and kidney tissues. It has previously been shown that lamellar bodies are present in hairy cells of organ of Corti, in the cytoplasm of secretory and lumen of tubal glands of Eustachian tube and kidney renal basement membrane. No evidence for the presence of surfactant proteins in the organ of Corti and kidney has been presented until now. The aim of this study was to find out if surfactant proteins were expressed in other epithelia such as organ of Corti, Eustachian tube and kidney. Surfactant proteins were identified using one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting. On one-dimensional Western blots, bands for surfactant protein A in human Eustachian tube (SP-A, 34 kDa) and in kidney extracts, and for surfactant protein D (SP-D, 43 kDa) in Eustachian tube and in kidney extracts (SP-D, 86 kDa), and for surfactant protein B (SP-B, 8 kDa) in human Eustachian tubeand organ of Corti extracts were detected. Bands corresponded to monomeric forms of lung surfactant proteins. These results indicate the presence of SP-A and SP-D in kidney epithelium, SP-A, SP-B and SP-D in Eustachian tube and SP-B in the organ of Corti.

2

Low doses of fenofibrate and bezafibrate stimulate renal 2-oxoglutarate dehydrogenase (2-OGDH) in protein-restricted rats

100%

Knapik-Czajka M. E., Drag J. M., Gawedzka A.

Acta Poloniae Pharmaceutica - Drug Research

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2020

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vol. 77

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issue 2

281-288

EN

2-oxoglutarate dehydrogenase (2-OGDH) is the key regulatory enzyme of cell metabolism. It has been previously demonstrated that in rats subjected to protein restriction low, clinically relevant doses of fibrates up-regulate liver 2-OGDH and promote 2-oxoglutarate catabolism. The aim of the present study was to evaluate the effect of low doses of fenofibrate and bezafibrate on renal 2-OGDH complex in rats fed low-protein chow. Fibrates were administrated for 14 days to Wistar male rats at one daily doses of 5, 10 and 20 mg/kg b.wt./day. The 2-OGDH activity was assayed spectrophotometrically. The mRNA levels for 2-OGDH catalytic subunits (E1 and E2) and PPARα were quantified by means of semi-quantitative reverse-transcription-PCR. 2-OGDH activity increased in response to administration of fenofibrate and bezafibrate (by 11, 24, 32% and 9, 12, 21%, respectively). The difference was statistically significant for the doses of 10 and 20 mg/kg b.wt of fenofibrate (p<0.001) and the highest dose of bezafibrate (p<0.05). Stimulation of 2-OGDH was not accompanied by changes in mRNA levels for E1 and E2. In addition, mRNA level for PPARα did not change. It is conceivable that fibrate-induced stimulation of 2-OGDH activity can affect renal metabolism and contribute to changes in kidney functions.

3

Embolization of iatrogenic renal arteriovenous fistula – a case report

100%

Kuklik E., Pyra K., Światłowski Ł., Kuczyńska M., Sobstyl J., Drelich-Zbroja A., Jargiełło T., Tsitskari M., Szczerbo-Trojanowska M.

Journal of Ultrasonography

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2018

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vol. 18

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issue 73

170-173

EN

Renal artery pseudoaneurysms and arteriovenous fistulae most often occur as an iatrogenic complication. The article discusses a case of a patient diagnosed with an arteriovenous fistula and a pseudoaneurysm. A 64-year-old woman was admitted to the hospital due to nonspecific pain in the lumbar region. Imaging showed a typical picture of clear cell renal carcinoma. The patient was qualified for surgical treatment. After tumor resection, the patient developed microhematuria. Arteriovenous fistula and renal pseudoaneurysm were diagnosed using Doppler and computed tomography scans. The patient was qualified for arteriography with simultaneous embolization of the lesion. A follow-up evaluation confirmed the exclusion of aneurysm and fistula. Treatment outcomes were monitored using Doppler ultrasound. Doppler ultrasonography is the first method of choice in detecting and monitoring renal artery irregularities. Safety, non-invasiveness and easy access to this tool make it play a key role in the diagnosis of renal artery fistulas and pseudoaneurysms.

PL

Pseudotętniaki tętnic nerkowych i przetoki tętniczo-żylne nerek pojawiają się najczęściej jako powikłania jatrogenne. W pracy omówiono przypadek chorej, u której w badaniu ultrasonograficznym i tomografii komputerowej rozpoznano przetokę tętniczo-żylną i tętniaka rzekomego, zlokalizowane w nerce prawej, a następnie leczonej metodami wewnątrznaczyniowymi. Sześćdziesięcioczteroletnia kobieta została przyjęta do szpitala z powodu niespecyficznych dolegliwości bólowych w okolicy lędźwiowej. Badania obrazowe wykazały typowy obraz dla jasnokomórkowego raka nerki. Chorą zakwalifikowano do leczenia chirurgicznego. Po resekcji klinowej u pacjentki obserwowano okresowy krwinkomocz. Za pomocą badania dopplerowskiego i tomografii komputerowej zdiagnozowano przetokę tętniczo-żylną i tętniaka rzekomego nerki prawej. Chorą zakwalifikowano do arteriografii z równoczasową embolizacją. Po zabiegu embolizacji badania kontrolne potwierdziły wyłączenie tętniaka i przetoki z krążenia. Wyniki leczenia monitorowano za pomocą badań dopplerowskich. Ultrasonografia dopplerowska jest metodą z wyboru w wykrywaniu i monitorowaniu nieprawidłowości tętnic nerkowych. Bezpieczeństwo, nieinwazyjność i dostępność badania sprawiają, że odgrywa ono kluczową rolę w diagnozowaniu przetok tętnic nerkowych i pseudotętniaków.

4

Laparoscopic Live-Donor Nephrectomy With Retroperitoneoscopic Access

100%

Słojewski M., Śluzar T., Umiński M., Sikorski A.

Polish Journal of Surgery

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2008

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vol. 80

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issue 8

413-416

EN

Live donation remains the single most consistent factor affecting long-term results of the transplantation. Open live donor nephrectomy is associated with high traumatization and possibility of complications due to large skin incision. The alternative is laparoscopic live donor nephrectomy (LDN) which is widely used in many countries. We present the case of LDN. The retroperitoneal approach was applied and time of operation was 210 min. The immediate function of transplanted kidney was observed. Authors hope that the offering this minimally invasive procedure to the potential donors may popularize the idea of live donation in Poland.

5

Urolithins and their possible implications for diabetic kidney

100%

Kotewicz M., Lewko B.

European Journal of Translational and Clinical Medicine

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2022

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vol. 5

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issue 1

53-63

EN

The increasing prevalence of diabetic kidney disease (DKD), a common complication of type 1 and type 2 diabetes, is becoming a leading risk factor of developing end stage renal disease (ESRD). The multiple mechanisms involved in renal tissue damage are a challenge for effective targeted therapy. Urolithins are metabolites generated by gut microbiota upon dietary intake of plant-derived elagitannins. Multidirectional effects of these compounds include their anti-inflammatory, antioxidant, anti-proliferatory, anti-migratory and antiglycative properties that are mediated by modulation of signaling pathways and gene expression. Biochemical properties of urolithins indicate their capacity to regulate numerous mechanisms responsible for developing the hyperglycemia-induced tissue injury. The potentially beneficial effects of urolithins on podocytes, the most vulnerable renal cells should be particularly considered. The purpose of this review is to provide the evidence from the in vivo and in vitro studies showing that urolithin-based therapy could be a useful tool for protecting the kidneys from damage in diabetes.

6

Renal vascularization anomalies in the Polish population

100%

Sośnik H., Sośnik K.

Polish Journal of Surgery

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2017

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vol. 89(6)

26-30

EN

Summary: The aim of the study was to determine the incidence of renal venous system congenital anomalies in the Polish population. Material and method: Vascular kidney samples were investigated by means of preparations and X-ray contrasting. The study the group comprised 281 male and 269 female specimens. Results: Congenital anomalies were diagnosed in 186 patients (33 8% of all cases), and they were more frequent in men than in women, albeit that difference was non-significant. The following anomalies were most commonly observed: multiple venous variations on the right side (20.4%), retroaortic course of the left renal vein (4.2%), and circumaortic venous ring of the left renal vein (3.8%). Other anomalies were diagnosed in 1%-2% of cases. Conclusions: Awareness and preoperative assessment of the venous system before abdominal aortic surgery, isolated collection of renal venous blood samples, and urological or kidney transplantation procedures is essential.

7

Vascular complications in patients with Autosomal Dominant Polycystic Kidney Disease. A review of the literature and current clinical recommendations

100%

Koska-Ścigała A., Zdrojewski Ł., Jankowska M., Dębska-Ślizień A.

European Journal of Translational and Clinical Medicine

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2020

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vol. 3

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issue 2

64-71

EN

Autosomal dominant polycystic kidney disease is the most common genetic cause of renal failure. Apart from kidney involvement, patients are at risk of extra-renal manifestations, including vascular lesions. The etiology of vascular changes is diverse and depends, among other factors, on polycystin gene mutation, increased activity of the renin-angiotensin-aldosterone system and the occurrence of hypertension. The observed vascular system complications include cerebral artery aneurysms, cervico-encephalic arteries' dissection, aortic aneurysm and dissection and intracranial arterial dolichoectasia. This article discusses the etiopathogenesis, symptomatology, principles of prevention and treatment of the aforementioned diseases of the vascular system accompanying polycystic kidney disease.

8

Atorvastatin improves tubular status in non-diabetic patients with chronic kidney disease - placebo controlled, randomized, cross-over study

88%

Renke M., Tylicki L., Rutkowski P., Neuwelt A., Larczyński W., Ziętkiewicz M., Aleksandrowicz E., Łysiak-Szydłowska W., Rutkowski B.

Acta Biochimica Polonica

|

2010

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vol. 57

|

issue 4

547-552

EN

Background. There is evidence that dyslipidemia is associated with chronic kidney disease (CKD) and it has been implicated in the progression of renal damage. Optimal management of dyslipidemia should therefore lead to renal benefits. A number of experimental models demonstrate a beneficial effect of statins in ameliorating renal damage. However, the exact mechanism by which statins protect against renal damage remains unclear. Methods. In a placebo-controlled, randomized, cross-over study we evaluated the influence of atorvastatin (ATO) 40 mg/day added to the renin-angiotensin-aldosterone systeme (RAAS) blockade on proteinuria and surrogate biomarkers of tubular damage or injury in 14 non-diabetic patients with proteinuria (0.4-1.8 g per 24 h) with normal or declined kidney function (eGFR 55-153 ml/min). In the eight-week run-in period, therapy using angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II subtype 1 receptor antagonists (ARB) was adjusted to achieve a blood pressure below 130/80 mm Hg. Next, patients were randomly assigned to one of two treatment sequences: ATO/washout/placebo or placebo/washout/ATO. Clinical evaluation and laboratory tests were performed at the randomization point and after each period of the study. The primary end point of this study was a change in proteinuria measured as 24-h urine protein excretion (DPE). Secondary end points included urine N-acetyl-β-d-glucosaminidase (NAG) and α1-microglobulin (α1m) excretion. Results. The ATO therapy significantly reduced urine excretion of α1m (p=0.033) and NAG (p=0.038) as compared to placebo. There were no differences in proteinuria, blood pressure, eGFR and serum creatinine between the ATO and placebo groups. Conclusion. Atorvastatin treatment is safe and improves biomarkers of tubular damage or injury in non-diabetic patients with CKD.

9

Silver (Ag) in tissues and eggshells, biochemical parameters and oxidative stress in chickens

88%

Chmielowiec-Korzeniowska A., Tymczyna L., Dobrowolska M., Banach M., Nowakowicz-Dębek B., Bryl M., Drabik A., Tymczyna-Sobotka M., Kolejko M.

Open Chemistry

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2015

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vol. 13

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issue 1

EN

This study aimed to assess levels of silver nanoparticle residues in eggshells and tissues as well as the levels of selected biochemical parameters and oxidative stress indices in chickens hatched from nanosilver disinfected eggs. The samples included 40 Greenleg Partridge chicks allocated into two groups. The experimental group (group D) consisted of chickens hatched from eggs disinfected with a nanosilver preparation prior to incubation, while the control group (group C) included chickens whose eggs were exposed to UV radiation for disinfection. The eggshells and kidney sections obtained from group D chickens showed a significantly higher silver level compared to group C. For the biochemical parameters, only the uric acid content was higher in group D compared to group C. Analysis of the antioxidative stress biomarkers (superoxide dismutase and catalase), showed a significant increase in group D in relation to group C.

10

Urgent arterial embolization of ruptured renal angiomyolipoma

75%

Kervancioglu S., Yilmaz F.

Open Medicine

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2014

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vol. 10

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issue 1

EN

The most undesired complication of renal angi- omyolipoma (AML) is bleeding. Because of tumor rupture, the bleeding can spread to the retroperitoneal field and can be severe enough to be life threatening. We report a case of retroperitoneal hemorrhage caused by a ruptured AML that was successfully treated with transarterial embolization with N-butyl cyanoacrylate.

11

Building a Web-Augmented Reality application for demonstration of kidney pathology for veterinary education

75%

Atmaca H. T., Terzi O. S., Atmaca H. T., Terzi O. S.

Polish Journal of Veterinary Sciences

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2021

12

Adeno-associated virus vector-mediated gene delivery to the vasculature and kidney.

75%

Kapturczak M. H., Chen S., Agarwal A.

Acta Biochimica Polonica

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2005

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vol. 52

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issue 2

293-299

EN

Relatively successful elsewhere, gene delivery aimed at the vasculature and kidney has made very little progress. In the kidney, the hurdles are related to the unique structure–function relationships of this organ and in the blood vessels to a variety of, mostly endothelial, factors making the delivery of transgenes very difficult. Among gene-therapeutic approaches, most viral gene delivery systems utilized to date have shown significant practical and safety-related limitations due to the level and duration of recombinant transgene expression as well as their induction of a significant host immune response to vector proteins. Recombinant adeno-associated virus (rAAV) vectors appear to offer a vehicle for safe, long-term transgene expression. rAAV-based vectors are characterized by a relative non-immunogenicity and the absence of viral coding sequences. Furthermore, they allow for establishment of long-term latency without deleterious effects on the host cell. This brief review addresses problems related to transgene-delivery to kidney and vasculature with particular attention given to rAAV vectors. The potential for gene therapy as a strategy for selected renal and vascular diseases is also discussed.

13

Consequences of the loss of the Grainyhead-like 1 gene for renal gene expression, regulation of blood pressure and heart rate in a mouse model

75%

Pawlak M., Walkowska A., Mlącki M., Pistolic J., Wrzesiński T., Benes V., Jane S., Wesoły J., Kompanowska-Jezierska E., Wilanowski T.

Acta Biochimica Polonica

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2015

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vol. 62

|

issue 2

287-296

EN

Aim: The Grainyhead-like 1 (GRHL1) transcription factor is tissue-specific and is very highly expressed in the kidney. In humans the GRHL1 gene is located at the chromosomal position 2p25. A locus conferring increased susceptibility to essential hypertension has been mapped to 2p25 in two independent studies, but the causative gene has never been identified. Furthermore, a statistically significant association has been found between a polymorphism in the GRHL1 gene and heart rate regulation. The aim of our study was to investigate the physiological consequences of Grhl1 loss in a mouse model and ascertain whether Grhl1 may be involved in the regulation of blood pressure and heart rate. Experimental approach: In our research we employed the Grhl1 "knock-out" mouse strain. We analyzed renal gene expression, blood pressure and heart rate in the Grhl1-null mice in comparison with their "wild-type" littermate controls. Most important results: The expression of many genes is altered in the Grhl1-/- kidneys. Some of these genes have previously been linked to blood pressure regulation. Despite this, the Grhl1-null mice have normal blood pressure and interestingly, increased heart rate. Conclusions: Our work did not discover any new evidence to suggest any involvement of Grhl1 in blood pressure regulation. However, we determined that the loss of Grhl1 influences the regulation of heart rate in a mouse model.

14

Effect of pentoxifylline on proteinuria, markers of tubular injury and oxidative stress in non-diabetic patients with chronic kidney disease - placebo controlled, randomized, cross-over study

75%

Renke M., Tylicki L., Rutkowski P., Knap N., Ziętkiewicz M., Neuwelt A., Aleksandrowicz E., Łysiak-Szydłowska W., Woźniak M., Rutkowski B.

Acta Biochimica Polonica

|

2010

|

vol. 57

|

issue 1

119-123

EN

Background: Inhibition of the renin-angiotensin-aldosterone system (RAAS) with angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II subtype 1 receptor antagonists (ARB) is a common strategy used in the management of patients with chronic kidney disease (CKD). However, there is no universal therapy that can stop progression of CKD. Pentoxifylline (PTE) is a non-specific phosphodiesterase inhibitor with anti-inflammatory properties. It has been reported to have promising effects in CKD treatment. Methods: In a placebo-controlled, randomized, cross-over study we evaluated the influence of PTE (1200 mg/day) added to RAAS blockade on proteinuria, surrogate markers of tubular injury and oxidative stress-dependent products in 22 non-diabetic patients with proteinuria (0.4-4.3 g per 24h) with normal or declined kidney function [eGFR 37-178 mL/min]. In an eight-week run-in period, therapy using ACEI and/or ARB was adjusted to achieve a blood pressure below 130/80 mm Hg. Next, patients were randomly assigned to one of two treatment sequences: PTE/washout/placebo or placebo/washout/PTE. Clinical evaluation and laboratory tests were performed at the randomization point and after each period of the study. Results: The PTE therapy reduced proteinuria (by 26%) as compared to placebo. There were no differences in α1-microglobulin, urine excretion of N-acetyl-β-d-glucosaminidase (NAG), hsCRP, the urinary excretion of 15-F2t-isoprostane, blood pressure (BP), eGFR and serum creatinine between the PTE and placebo groups. Conclusion: Pentoxifylline may decrease proteinuria in non-diabetic patients with CKD.

15

Spectrophotometric method for the determination of renal ouabain-sensitive H+,K+ -ATPase activity.

75%

Bełtowski J., Wójcicka G.

Acta Biochimica Polonica

|

2002

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vol. 49

|

issue 2

515-527

EN

The aim of this work was to develop a method for renal H+,K+-ATPase measurement based on the previously used Na+,K+-ATPase assay (Bełtowski et al.: J Physiol Pharmacol.; 1998, 49: 625-37). ATPase activity was assessed by measuring the amount of inorganic phosphate liberated from ATP by isolated microsomal fraction. Both ouabain-sensitive and ouabain-resistant K+-stimulated and Na+-independent ATPase activity was detected in the renal cortex and medulla. These activities were blocked by 0.2 mM imidazolpyridine derivative, Sch 28080. The method for ouabain- sensitive H+,K+-ATPase assay is characterized by good reproducibility, linearity and recovery. In contrast, the assay for ouabain-resistant H+,K+-ATPase was unsatisfactory, probably due to low activity of this enzyme. Ouabain-sensitive H+,K+-ATPase was stimulated by K+ with Km of 0.26 ± 0.04 mM and 0.69 ± 0.11 mM in cortex and medulla, respectively, and was inhibited by ouabain (Ki of 2.9 ± 0.3 μM in the renal cortex and 1.9 ± 0.4 μM in the renal medulla) and by Sch 28080 (Ki of 1.8 ± 0.5 μM and 2.5 ± 0.9 μM in cortex and medulla, respectively). We found that ouabain-sensitive H+,K+-ATPase accounted for about 12% of total ouabain-sensitive activity in the Na+,K+-ATPase assay. Therefore, we suggest to use Sch 28080 during Na+,K+-ATPase measurement to block H+,K+-ATPase and improve the assay specificity. Leptin administered intraperitoneally (1 mg/kg) decreased renal medullary Na+,K+-ATPase activity by 32.1% at 1 h after injection but had no effect on H+,K+-ATPase activity suggesting that the two renal ouabain-sensitive ATPases are separately regulated.

16

Regulation of renal Na+,K+ -ATPase and ouabain-sensitive H+,K+ -ATPase by the cyclic AMP-protein kinase A signal transduction pathway.

75%

Bełtowski J., Marciniak A., Wójcicka G., Górny D.

Acta Biochimica Polonica

|

2003

|

vol. 50

|

issue 1

103-114

EN

We investigated the effect of the cyclic AMP-protein kinase A (PKA) signalling pathway on renal Na+,K+-ATPase and ouabain-sensitive H+,K+-ATPase. Male Wistar rats were anaesthetized and catheter was inserted through the femoral artery into the abdominal aorta proximally to the renal arteries for infusion of the investigated substances. Na+,K+-ATPase activity was measured in the presence of Sch 28080 to block ouabain-sensitive H+,K+-ATPase and improve specificity of the assay. Dibutyryl-cyclic AMP (db-cAMP) administered at a dose of 10-17 mol/kg per min and 10-6 mol/kg per min increased Na+,K+-ATPase activity in the renal cortex by 34% and 42%, respectively, and decreased it in the renal medulla by 30% and 44%, respectively. db-cAMP infused at 10-6 mol/kg per min increased the activity of cortical ouabain-sensitive H+,K+-ATPase by 33%, and medullary ouabain-sensitive H+,K+-ATPase by 30%. All the effects of db-cAMP were abolished by a specific inhibitor of protein kinase A, KT 5720. The stimulatory effect on ouabain-sensitive H+,K+-ATPase and on cortical Na+,K+-ATPase was also abolished by brefeldin A which inhibits the insertion of proteins into the plasma membranes, whereas the inhibitory effect on medullary Na+,K+-ATPase was partially attenuated by 17-octadecynoic acid, an inhibitor of cytochrome P450-dependent arachidonate metabolism. We conclude that the cAMP-PKA pathway stimulates Na+,K+-ATPase in the renal cortex as well as ouabain-sensitive H+,K+-ATPase in the cortex and medulla by a mechanism requiring insertion of proteins into the plasma membrane. In contrast, medullary Na+,K+-ATPase is inhibited by cAMP through a mechanism involving cytochrome P450-dependent arachidonate metabolites.

17

Kidney Segmentation in CT Data Using Hybrid Level-Set Method with Ellipsoidal Shape Constraints

75%

Skalski A., Heryan K., Jakubowski J., Drewniak T.

Metrology and Measurement Systems

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2017

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vol. 24

|

issue 1

18

Urazy nerek – objawy i diagnostyka

63%

Ząbkowski T., Skiba R., Grabińska A., Maliborski A., Syryło T., Zieliński H.

Pediatria i Medycyna Rodzinna

|

2013

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vol. 9

|

issue 3

263-266

EN

The authors present the classification, symptoms and diagnostic methods of renal injuries. These injuries can be life-threatening, but most of them are mild and can be managed conservatively. No less than 75% patients who were diagnosed with renal injuries are men. The group which is particularly exposed to renal injuries are young men doing sports, the injured of road accidents, victims of accidents in the house or at work, victims of fights and assaults. The results of conducted studies indicate that haematuria, pain and ecchymosis in the lumbar region, fractured ribs as well as abdominal mass can be the symptoms of renal injury. There are blunt and penetrating renal injuries as well as a 5-level classification of kidney injuries according to a degree of injuries – AAST. This classification enables to perform a standardization of different patient groups to choose a proper therapy and to predict the results of treatment. The mechanism of injury, its placement and severity are the standard guidelines within a choice of diagnostic methods and indications for treatment’s strategy. The imaging examinations are necessary in diagnostics of abdomen injuries with a suspicion of renal injury. Among the imaging examinations used in diagnostics of injuries of urogenital system and renal injuries it is to enumerate: ultrasonography, computed tomography, urography, arteriography and angiography. Computed tomography of abdomen with contrast injected into an intravenous line is a gold standard in diagnostics of renal injuries. If computed tomography is not available, it is recommended to perform ultrasonography as an examination of first choice.

PL

Autorzy przedstawiają klasyfikację, objawy i metody diagnostyczne urazów nerek. Urazy te mogą zagrażać życiu, jednak większość z nich ma łagodny przebieg i można je leczyć zachowawczo. Aż 75% pacjentów, u których stwierdzono uszkodzenia nerek, to mężczyźni. Grupę szczególnie narażoną stanowią młodzi mężczyźni uprawiający sport, uczestnicy wypadków drogowych, ofiary wypadków w domu lub w miejscu pracy, ofiary bójek i napadów. Z przeprowadzonych badań wynika, że objawami urazu nerek mogą być: krwiomocz, bóle i zasinienia w okolicach lędźwiowych, złamania żeber, napięty brzuch. Wyróżnia się urazy tępe i penetrujące oraz pięciostopniową klasyfikację urazów nerek według stopnia odniesionych obrażeń – AAST. Klasyfikacja ta pozwala na dokonanie pewnej standaryzacji różnych grup pacjentów i wyboru właściwej terapii oraz stwarza możliwość przewidywania wyników leczenia. Mechanizm urazu, jego umiejscowienie i ciężkość stanowią podstawowe wytyczne w wyborze metod diagnostycznych oraz postępowania leczniczego. Niezbędnym elementem diagnostyki urazu jamy brzusznej z podejrzeniem uszkodzenia nerek jest wykonanie badań obrazowych. Wśród badań obrazowych mających zastosowanie w diagnostyce urazów układu moczowo-płciowego oraz nerek należy wymienić: ultrasonografię, tomografię komputerową, urografię, angiografię i arteriografię. Tomografia komputerowa jamy brzusznej z dożylnym podaniem środka cieniującego stanowi złoty standard w diagnostyce urazów nerek. Przy braku dostępności tomografii komputerowej zalecane jest wykonanie ultrasonografii jako badania pierwszego rzutu.

19

Kidney ultrasound – what is important for a urologist?

63%

Szopiński T., Keller E., Záťura F.

Journal of Ultrasonography

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2016

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vol. 16

|

issue 67

371-377

EN

Kidney ultrasound is one of the basic procedures in the practice of a urologist. Apart from the location and the size, description of renal morphology should contain the thickness of the anterior lip parenchyma in a transverse section and the location of possible narrowings. Uneven outline of the kidney is a sign of past inflammatory conditions. In the case of the pelvicalyceal system dilation, it is advised to specify the dimensions of the pelvis and calyces. Convex shape of the calyces proves elevated pressure within the pelvicalyceal system. Hydronephrosis is present when urinary retention has led to thinning the renal parenchyma. In each case, one should identify the reason for urinary retention in the upper urinary tract. Urinary retention on both sides requires one to exclude urinary bladder tumor, it may also be caused by a benign prostatic hyperplasia. Ultrasound examination is a sensitive method of renal stones detection, regardless of their chemical composition. Cyst description in an ultrasound image should cover its morphological features, differentiating between the so-called simple or complex cysts. In the case of a solid lesion, ultrasound makes it possible to detect parenchymal lesions usually starting with the size of 2–2.5 cm. It enables one to particularly diagnose angiomyolipomas. As regards the remaining parenchymal lesions, differentiation of the lesion nature is impossible. In some cases of angiomyolipoma, when it contains bleeding areas present and when it is deficient in adipose tissue, it resembles adenocarcinoma. It is necessary that the description includes the exact location, especially the dimensions and relation of the tumor to the renal sinus. In the case of larger lesions, respiratory motion of the kidney, the condition of the adrenal gland and the presence of enlarged lymph nodes should be controlled. Additionally, one should evaluate the renal vein and inferior vena cava in terms of a neoplastic plug presence.

PL

Badanie ultrasonograficzne nerek jest jednym z podstawowych badań w praktyce urologa. Oprócz położenia i wielkości narządu opis morfologii nerek powinien zawierać grubość miąższu wargi przedniej na przekroju poprzecznym oraz miejsca jego ewentualnych przewężeń. Nierówne zarysy zewnętrzne nerki świadczą o przebytych stanach zapalnych. W przypadku poszerzenia układu kielichowo-miedniczkowego wskazane jest podanie wymiarów miedniczki i kielichów. O podwyższonym ciśnieniu w obrębie układu kielichowo-miedniczkowego świadczy wypukły kształt kielichów. Wodonercze pojawia się wówczas, gdy zastój moczu doprowadził do ścieńczenia miąższu nerki. W każdym przypadku należy zidentyfikować przyczynę zastoju moczu w górnych drogach moczowych. Obustronny zastój moczu wymaga wykluczenia guza pęcherza moczowego, może też wynikać z łagodnego rozrostu stercza. Badanie ultrasonograficzne jest czułą metodą wykrywania złogów, niezależnie od ich składu chemicznego. Opis torbieli w badaniu ultrasonograficznym powinien obejmować jej cechy morfologiczne, różnicujące tzw. torbiele proste oraz złożone. W przypadku zmian litych ultrasonografia pozwala na wykrycie zmian miąższowych zazwyczaj od wielkości 2–2,5 cm. W szczególny sposób pozwala zdiagnozować guzy typu naczyniakomięśniakotłuszczaka. W odniesieniu do pozostałych zmian miąższowych nie jest możliwe zróżnicowanie charakteru zmiany. W niektórych przypadkach naczyniakomięśniakotłuszczak, gdy zawiera obszary krwawień oraz gdy jest ubogi w tkankę tłuszczową, upodabnia się do gruczolakoraka. W opisie konieczne jest uwzględnienie dokładnej lokalizacji, zwłaszcza wymiarów i stosunku guza do zatoki nerkowej. W przypadku większych zmian należy skontrolować ruchomość oddechową nerki, stan nadnercza i obecność powiększonych węzłów chłonnych. Dodatkowo powinno się ocenić żyłę nerkową i główną dolną pod kątem obecności czopa nowotworowego.

20

Acoustic radiation force impulse imaging of kidneys – a phantom study

63%

Cygan S., Januszewicz M.

Journal of Ultrasonography

|

2016

|

vol. 16

|

issue 67

329-338

EN

Aim of the study: Since there have been only few works reporting the diagnosis of kidneys using Acoustic Radiation Force Impulse technique and those works do not provide consistent results of shear wave velocity measurements in renal tissue, we have decided to use kidney phantoms with known properties to examine the reliability of the method itself in a controlled setup similar to kidneys examination. Materials and methods: Four gelatin-based phantoms imitating different clinical situations were manufactured – two with thick and two with thin renal cortex, each type at a depth similar to a normal-weight or overweight patient. For each phantom, a series of interest points was chosen and for each point 20 Shear Wave Velocity measurements were taken using the build-in Virtual Touch Tissue QuantificationTM tool in a Siemens Acuson S2000 ultrasound scanner equipped with a 6C1 HD Transducer (Siemens Mountainview, USA). Results: Mean Shear Wave Velocity values obtained for all the examined points ranged from 2.445 to 3.941 m/s, with standard deviation exceeding 0.1 in only one case out of 29 points, but differing significantly between all points. Conclusions: The obtained results indicate that the method is highly reliable as long as the measurement volume contains a uniform tissue region. If the measurement window covers a region with different properties even partially, the obtained results are affected. The variance of measured values on the other hand is not affected by the said non-uniformity of material under examination. Furthermore, the variance of measured values does not show a clear dependency on the depth at which the shear wave velocities are measured.

PL

Cel pracy: Ze względu na skąpość doniesień naukowych dotyczących diagnostyki nerek za pomocą elastografii impulsu mocy promieniowania akustycznego oraz niejednoznaczność prezentowanych wyników pomiarów prędkości propagacji fali ścinającej autorzy postanowili wykorzystać fizyczne modele tkankowe nerek w celu sprawdzenia wiarygodności samej metody w kontrolowanych warunkach, zbliżonych do panujących podczas diagnostyki tego narządu. Materiały i metody: Przygotowane zostały cztery fantomy żelatynowe odpowiadające różnym warunkom klinicznym – dwa o normalnej i dwa o cienkiej warstwie miąższowej, każdy na głębokości dostosowanej do pacjenta o normalnej budowie i otyłego. W każdym fantomie wybrane zostały punkty zainteresowania i w każdym z nich wykonano 20 pomiarów prędkości propagacji fali ścinającej. Zostały one przeprowadzone przy pomocy wbudowanej funkcji Virtual Touch Tissue QuantificationTM ultrasonografu Siemens Acuson S2000, wyposażonego w głowicę 6C1 HD (Siemens Mountainview, USA). Wyniki: Średnie wartości prędkości fali ścinającej zarejestrowane we wszystkich punktach zainteresowania zawierały się w zakresie od 2,445 do 3,941 m/s, z odchyleniem standardowym przekraczającym 0,1 m/s tylko w jednym z 29 punktów pomiarowych. Różnice wartości w poszczególnych punktach były statystycznie istotne. Wnioski: Uzyskane wyniki pokazują, że metoda będąca przedmiotem zainteresowania jest wysoce wiarygodna pod warunkiem, że w objętości pomiarowej znajduje się jednorodna struktura. Jeśli okno pomiarowe obejmuje choćby częściowo region o innych właściwościach, to wynik pomiaru zostaje zniekształcony. Wariancja wyników pomiarów w takim przypadku zostaje zachowana. Co więcej, na wariancję wyników pomiarów prędkości fali ścinającej nie ma wpływu głębokość, na jakiej pomiary są dokonywane.

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