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07335cam a2200433 i 4500 |
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20221201133528.0 |
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|9 (HR-ZaNSK)140490
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|9 (HR-ZaNSK)960201062
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|a (HR-ZaNSK)000140339
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|a 616.61-008.6-085
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|a 612.466.089
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|a Krhen, Ivan
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|a Utjecaj opstrukcije mokraćovoda na koncentraciju gentamicina u tkivu bubrega i mokraći u pokusnih životinja :
|b doktorska disertacija /
|c Ivan Krhen.
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|a Zagreb :
|b I. Krhen,
|c 1995
|e ([s. l. :
|f s. n.])
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|a 133 lista :
|b ilustr. djelomično u bojama, table, graf. prikazi ;
|c 30 cm.
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|a mentor: Zvonimir Mareković; Komisija za ocjenu: Igor Francetić, Juraj Geber, Ante Svetina, Stipe Batinica, Zvonimir Mareković; Komisija za obranu: Igor Francetić, Juraj Geber, Ante Svetina, Stipe Batinica, Zvonimir Mareković; datum obrane: 14.12.1995; datum promocije:
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|a Sveučilište u Zagrebu, Medicinski fakultet, Zagreb, 1995
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|a Bibliografija: str. 119-132
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|a Summary
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|a Sažetak: U šezdeset i jednog zamorčeta soja Hartley operacijskim postupkom izazvana je jednostrana opstrukcija podvezivanjem mokraćovoda. Prema vremenskom trajanju opstrukcije zamorčad je podijeljena u tri skupine. U prve skupine životinja jednostrana opstrukcija trajala je 24 sata, u druge 7 dana, a u treće skupine životinja opstrukcija je trajala tri tjedna uz urednu prohodnost drugog mokraćovoda. Nakon 24-satne, jednotjedne i trotjedne jednostrane opstrukcije životinje su primile po 5 mg garamicin sulfata po kilogramu tjelesne težine (Garamicin, "Krka") tri puta u razmaku od 12 sati. Dva sata nakon zadnje intraperitonijske doze gentamicina sve tri skupine zamorčadi ponovo su podvrgnute operacijskom zahvatu. Posebnom štrcaljkom uzima se mokraća opstruiranog bubrega, a posebnom mokraća iz mokraćnog mjehura.
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|a Nakon žrtvovanja životinja uzima se opstruirani i neopstruirani bubreg. Zatim se važu i odvaja se kora od medule. Analizira se težina opstruiranog i neopstruiranog bubrega kao i težina medule bubrega u opstrukciji i težina medule neopstruiranog bubrega. Težina opstruiranog i neopstruiranog bubrega tijekom trotjedne opstrukcije podložna je promjeni pripadajućeg mu para. Nakon posebne obrade kore i medule bubrega kao i mokraće opstruiranog i neopstruiranog bubrega određuje se koncentracija gentamicina u tkivu i mokraći opstruiranog i neopstruiranog bubrega. Koncentracija gentamicina određuje se mikrobiološkom metodom, metodom difuzije na agaru. Nakon statističke analize podataka zabilježene su značajne razlike u koncentraciji gentamicina u tkivu i mokraći neopstruiranog bubrega i opstruiranog pripadajućeg mu para.
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|a S duljinom trajanja opstrukcije očigledan je pad koncentracije gentamicina u tkivu i mokraći opstruiranog bubrega. Istovremeno s koncentracijom antibiotika u tkivu i mokraći opstruiranog i neopstruiranog bubrega analizira se elektrolitski status mokraće opstruiranog i neopstruiranog bubrega te vrijednosti kreatinina. Iako su uočene promjene u koncentraciji kreatinina i elektrolita u opstruiranom bubregu u prvim satima trajanja opstrukcije izraženije su elektrolitske promjene. Ove promjene ukazuju na jače tubulsko oštećenje. Rana subklinička oštećenja bubrega praćena su na temelju enzimatske aktivnosti tubulskih enzima AAP i NAG u mokraći opstruiranog i suprotnog neopstruiranog bubrega.
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|a Iz analize koncentracije ovih enzima vidljivo je da gentamicin, kao antibiotik, ne izaziva samo porast koncentracije tubulskih enzima u mokraći opstruiranog bubrega, već je vidljiv i porast ovih enzima u mokraći neopstruiranog bubrega u odnosu na koncentraciju enzimske aktivnosti kontrolne skupine. Stoga je cilj ovog rada uputiti kliničare na nužnost ranog oslobađanja bubrega od opstrukcije kako bi se izbjegla trajna oštećenja bubrežnih funkcija. Na istom ili sličnom životinjskom modelu moguće je izučavati izlučivanje drugih antibiotika te drugih lijekova i njihovo djelovanje na opstruirani bubreg.
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|a Summary: Unilateral ureteral obstruction was created surgically in the total of 61 Hartley type guinea-pigs. According to the duration of obstruction animals were divided into three groups. 24-hour, 7-day and 3-week unilateral obstruction with normal contralateral ureteral function was reported in the first, second and third group, respectively. After 24-hour, 1-week and 3-week obstruction, animals received 5 mg of garamicin sulphate per kg/body weight three times during a 12-hour interval. All animals were surgically treated two hours after the last intraperitoneal dose of gentamicin. Urine samples from obstructed kidney and from urinary bladder were collected by special syringes. Obstructed and unobstructed kidneys were taken from the sacrificed animals. After being weighed, the cortex is divided from the medulla.
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|a The weight of obstructed and unobstructed renal cortex and medulla is analyzed. The weight of obstructed and unobstructed kidney during a three-week obstruction is prone to changes in unilateral ureteral obstruction. After special treatment of the renal cortex and medulla, together with the urine sample of the obstructed and unobstructed kidney, gentamicin concentration is defined microbiologically in the tissue and urine of the obstructed and unobstructed kidney. Statistical analysis reports significant differences of gentamicin concentrations in the tissue and urine of obstructed and unobstructed kidney. Decreased gentamicin concentration in tissue and urine of obstructed kidney is related with the duration of obstruction.
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|a Urinary electrolytes and creatinine values of obstructed and unobstructed kidney are analyzed simultaneously with the concentration of antibiotic in the tissue and urine of the obstructed kidney. Irrespective of the changes in the concentration of creatinine and urinary electrolytes in the obstructed kidney, more pronounced changes in the concentration of urinary electrolytes are observed during the first few hours of obstruction indicating to a more severe tubular damage. Early subclinical renal damages are monitored by following the enzymatic activity of tubular AAP and NAG urinary enzymes in obstructed and unobstructed contralateral kidney.
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|a The analysis shows that gentamicin, as a widely used aminoglycoside antibiotic, is related not only to increased concentration of tubular urinary enzymes in obstructed kidney, but to an elevated peak of these urinary enzymes in unobstructed kidney, as compared to the same enzymatic concentration in the control group. Thus, this work is aimed to remind of the necessary and early relief of obstruction to avoid permanent renal damages. Secretion of other antibiotics and their effect on obstructed kidney can be studied on a similar sample.
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| 650 |
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|a Mokraćni sustav
|x Bolesti
|x Farmakoterapija
|2 nskps
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| 981 |
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|p CRO
|r HRB1995
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| 998 |
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|n DCD
|c sbno9802
|c rjkp9803
|c jvli9803
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| 852 |
4 |
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|j DCD-ZG-13/96
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| 876 |
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|e DCD
|a 13/1996
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| 886 |
0 |
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|2 unimarc
|b 07033iam0 2200361 450
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