[Analysis of results of percutaneous nephrolithotomies]

BACKGROUND

Percutaneous nephrolithotomy is an effective less invasive method for the treatment of nephrolithiasis. Authors retrospectively analysed results of this procedure performed in a single centre (Department of Urology, General University Hospital, Prague) from January 2005 till June 2007.

METHODS AND RESULTS

Patients were acquired by an analysis of operating reports performed over a period January 2005 till June 2007 and subsequently a retrospective analysis of electronic and paper patient's records was carried out. Percutaneous nephrolithotomy was performed in 150 patients. Of those, 117 (78%) patients underwent primary and 33 (21.3%) secondary procedure. Analysed group consisted of 85 (56.7%) men and 65 (43.3%) women. Right-sided procedure was performed in 46% (69 times) and left-sided in 54% (81 times) of cases. Mean patient's age was 52.9 years (SD +/- 16.3). Mean stone size was 18.3 (SD +/- 9.5) mm. Staghorn calculi were present in 19 (12.7%) patients and 77 (51.3%) patients had more than 1 stone. Intracorporeal lithotripsy was necessary in 82 (54.7%) cases. Seventy eight (52.9%) patients were stone free after the procedure. There were 24 (16%) patients with an anatomic abnormality of upper urinary tract. The most common (in 64.3%) component in analysed stones was a calcium oxalate.

CONCLUSIONS

The amount of stone free patients is rather lower compared to the literature results. However, definitive results are always affected by auxiliary procedures (mainly extracorporeal shock wave lithotripsy), which are not included in the analysis.

Pituitary adenylate cyclase-activating polypeptide does not colocalize with vasoactive intestinal polypeptide in the hypothalamic magnocellular nuclei and posterior pituitary of cats and rats

Pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intestinal polypeptide (VIP) immunoreactive cells were demonstrated in the hypothalamic magnocellular nuclei in cats and rats. In cats these immunoreactive cells were stained without any treatment or intervention; however, in rats we had to use the pituitary stalk section to enhance the amount of PACAP and VIP for successful immunostaining. In both species the regions occupied by PACAP and VIP immunoreactive cells partially overlap each other in the paraventricular and supraoptic nuclei. Nevertheless, in either cats or rats PACAP and VIP immunoreactivities do not colocalize in the same cells studied by double labeling immunohistochemistry (IHC) or by the combination of immunohistochemistry and in situ hybridization. As was expected, PACAP and VIP immunoreactive materials were stored in different fibers of the posterior pituitary where the distribution of PACAP and VIP fibers also showed different patterns: PACAP fibers form a dense plexus at the periphery of the posterior lobe, in the vicinity of the intermediate lobe; however, the VIP fibers were evenly distributed mainly in the center of the posterior lobe. In spite of the high sequence homology of PACAP and VIP, the two peptides are synthesized in different subpopulations of hypothalamic neurons. This different distribution correlates well with the different role of the hypothalamic PACAP and VIP in the biologic clock and in the functions of the anterior and posterior pituitary.

PACAP and VIP in the photoneuroendocrine system (PNES)

The presence of PACAP and VIP was demonstrated in all the four levels of the photoneuroendocrine system (PNES) with the use of immunohistochemistry (IHC), radioimmunoassay (RIA), anterograde and retrograde tracing techniques, and cell immunoblot assay (CIBA). Both peptides play a physiological role in the PNES. According to our results both PACAP and VIP are involved in the regulation of the gonadotrop hormone secretion and their inhibitory role may be mediated through the neuronal chain of the PNES.