The Role of P2Y6 Receptors in the Mechanisms of the Neuroprotective Effect of Citicoline.

Spontaneous bioelectrical activity of the brain and the duration of gasping were recorded in mice during modeling of global strangulation ischemia of the brain against the background of preventive administration of citicoline. The maximum neuroprotective effect of citicoline was observed when it was administered 60 min before the simulation of ischemia and was completely prevented by preliminary administration of a selective P2Y6 receptor antagonist MRS2578. The obtained experimental data attest to the leading role of receptor mechanisms in the implementation of neuroprotective activity of citicoline.

Effect of cyclopentyladenosine on lipid peroxidation during focal cerebral ischemia.

The antioxidant effect of an adenosine A1 receptor agonist cyclopentyladenosine was studied on the model of focal cerebral ischemia. Ischemic injury of the brain was accompanied by changes in LPO processes (in the blood and brain tissue) and failure of some factors for antioxidant protection (peroxidase and catalase) that inactivate reactive metabolites. Changes in the ratio between LPO and antioxidant protection were less pronounced after treatment with cyclopentyladenosine.

Functional and metabolic changes in the brain in neuropathic pain syndrome against the background of chronic epidural electrostimulation of the spinal cord.

Changes in functional and metabolic activities of the brain were evaluated by EEG and positron-emission/computer tomography with 18F-fluorodeoxyglucose in patients with neuropathic pain syndrome previous to and 3 months after implantation of a system for chronic epidural spinal cord stimulation. In most cases, the use of a nerve stimulator was followed by alleviation of neuropathic pain and partial normalization of functional and metabolic activities of brain structures responsible for pain perception, emotiogenic, behavioral, and autonomic responses.

[Anticonvulsant and neuroprotective effects of cyclopentyladenosine on the model of convulsive status in rats].

The neuroprotective and anticonvulsant effects of cyclopentyladenosine (CPA) have been studied on a new experimental model of the convulsive status in rats aged 3-4 months and 10 days. The convulsive status was modeled by intracerebroventricular injection of ferakril (water-soluble polymer of polyacrylic acid) solution. It is established that prophylactic administration of CPA results in a relatively lower degree of neurological deficit, both in the acute phase and on the next day, compared to the untreated control. Considering that adenosine receptor agonists are analogs of the natural metabolites that have minimal side effects and expressed neuroprotective properties, the use of agents of this group is perspective for both prevention and treatment of seizure conditions in neurology and neurosurgery.

[Effect of cyclopentyladenosine on the orientation, exploratory, and emotional behavior of rats with model brain injury].

Effects of a local compression brain injury and the preventive application of cyclopentyladenosine (CPA) on the behavior of rats in the open field test was investigated. It is established that the local injury of a parietal cortex causes intensification of the orientation--research behavior and an increase in the emotional stress in rats. A protective action of CPA was manifested by a decrease in the expressiveness and duration of disturbances in the emotional and orientation--research behavior of animals in the open field test.

[Protective effect of cyclopentyladenosine in a minimally invasive model of acute cerebral focal ischemia in rats]. / Zashchitnoe deistvie tsiklopentiladenozina na maloinvazivnoi modeli ostroi fokal'noi ishemii golovnogo mozga u krys.

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.

[Protective effect of adenosine receptor agonists in a model of spinal cord injury in rats]. / Zashchitnoe deistvie agonistov adenozinovykh retseptorov na modeli travmaticheskogo povrezhdeniia spinnogo mozga u krys.

Possibilities of the neuroprotector therapy using adenosine and cyclopentyladenosine (CPA), an adenosine receptor agonist, were studied on a model of spinal cord injury by compression in rats (most closely reproducing the analogous clinical pathological process in humans). The model was induced by slow, graded compression of the spinal cord at the thoracic level. Adenosine and CPA were introduced 60 min before injury by subcutaneous injections in a dose of 300 and 2.5 micrograms/kg, respectively. The protective effect was judged by comparing the neurological, electromyographic, and histopathological changes in animals with the model injury and in the control group (adenosine and CPA background). The A1-agonist CPA injections produced a pronounced, statistically significant neuroprotector effect on the given spinal cord injury model in rats. The neuroprotective effect of adenosine was significant but not as strong. It is concluded that it is expedient to use A-agonists in clinics.

[Protective effect of A-agonists in a minimum invasive model of spinal cord ischemia in rats]. / Zashchitnoe deistvie A-agonistov na maloinvazivnoi modeli ishemii spinnigo mozga u krys.

The neuroprotective properties of N6-cyclohexyladenosine (CHA) and N6-cyclopentyladenosine (CPA), adenosine receptor agonists (A-agonists), were studied on a model of spinal cord ischemia (SCI) in rats (most closely reproducing the analogous clinical pathological process in humans). The SCI model was induced by intravasal occlusion of the abdominal aorta and its branches. CHA and CPA were introduced by intracerebroventricular injections in a dose of 25 micrograms/kg, 60 min before SCI induction. The protective effect was judged by comparing the patterns of neurological and histopathological disturbances in the untreated control (ischemia) and on the CHA or CPA background. The A-agonist CPA produced a pronounced, statistically reliable neuroprotector effect on the minimum invasive SCI model studied. CHA is also a statistically reliable but less effective neuroprotector. The A-agonists may have good prospects in clinics.

[Minimum-invasive model of the rat brain focal ischemia]. / Maloinvazivnaia model' fokal'noi ishemii golovnogo mozga u krys.

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.

[Transthoracic approach in surgery of the kidneys]. / Transtorakal'nyi dostup pri operatsiiakh na pochke.

Under analysis were clinical observations of 37 patients who were subjected to transthoracal nephrectomy. Positive sides and advantages of transthoracal nephrectomies were noted. Preliminary embolization of the arterial bed of the kidney was shown to be not expedient in the surgical procedure in question. It is emphasized that in carcinoma of the kidney the above mentioned access is the access of choice. Wider introduction of the method into the every-day urological practice is recommended.

[Perestroika in the surgery of renal tuberculosis and its scientific substantiation]. / Perestroika v khirurgii nefrotuberkuleza i ee nauchnoe obosnovanie.

Based on vast experimental studies and many-years personal experience on the conservative and surgical treatment of tuberculosis of the kidneys the author has made a conclusion of a necessary change of all the work for the detection and treatment of nephrotuberculosis. Of primary importance is the organisation of early diagnostics of focal tuberculosis of the renal parenchyma and its radical-prophylactic surgical treatment, preventing the development of spreaded and neglected forms of the disease. To organize this work it is necessary to accept the new pathogenetically substantiated evolutionary classification of tuberculosis of the kidneys dividing the development of the disease into 4 stages.

[Radical-preventive surgery in cavernous tuberculosis of the kidneys]. / Radikal'no-profilakticheskie operatsii pri kavernoznom tuberkuleze pochek.

On the model of focal-caseous tuberculosis of kidneys in 210 rabbits it was proved that effects of antibacterial drugs in any concentration have their limits and fail to liquidate the cavernous injuries of the renal parenchyma. The investigation of long-term results of the conservative treatment of 153 patients with the cavernous tuberculosis of kidneys has completely confirmed the conclusions of experimental investigations. An analysis of long-term results of organ-preserving focal operations in experiments and clinic gave a substantial support to a real possibility to cure the pathological process. The author points to an importance to revise the idea of the leading role of the conservative antibacterial therapy in favor of wider using radical-prophylactic operations in limited cavernous tuberculosis of kidneys.

[Pathogenetic justification of organ-preserving operations and their role in improving the effectiveness of the comprehensive treatment of renal tuberculosis]. / Patogeneticheskoe obosnovanie organosokhraniaiushchikh operatsii i ikh rol' v povyshenii éffektivnosti kompleksnogo lechenii tuberkuleza pochek.

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.

[Surgical treatment of tuberculosis of the single kidney]. / O Khirurgicheskom lechenii tuberkuleza edinstvennoi pochki.

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.

[Embolization of the renal artery in the treatment of surgical kidney diseases]. / Embolizatsiia pochechnykh arterii v lechenii khirurgicheskikh zabolevanii pochek.

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.

[Organ-sparing surgical treatment of retention-inflammatory diseases of the kidneys]. / Organosokhraniaiushchee khirurgicheskoe lechenie retentsionno-vospalitel'nykh zabolevanii pochek.

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).

[Regional infusion and superselective embolization in organ-preserving surgical treatment of kidney diseases]. / Regionarnaia infuziia i superselektivnaia émbolizatsiia pri organosokhraniaiushchem lechenii zabolevanii pochek.

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.

[Rare forms of ureteral pathology in surgical practice]. / Redkie formy patologii mochetochnika v khirurgicheskoi praktike.

Clinical observations of two patients are described. Direct vesicopelvic anastomosis was fulfilled in both of them: in one patient--in autotransplantation of the left kidney, in the other--in pelvic dystopia of the hydronephrotically altered right kidney. Clinical recovery and perfect restoration of working capacity of the patients was obtained. None of them had vesicopelvic refluxes.

[Elaboration of organ-sparing operations in cavernous tuberculosis of the kidneys]. / Obosnovanie organosokhraniaiushchikh operatsii pri kavernoznom tuberkuleze pochek.

A clinico-experimental study was performed in 132 rabbits and 8 patients. The formation of so-called "giant caverns" is thought by the authors to be due to disturbed vascularization of proximal portions of the tubules resulting in their gradual destruction and fusion. The necessary removal of not only the superficial retention structures erroneously called "giant cavern" but also the somewhat deeper caseous-cavernous tuberculosis focus is stressed.

[Autotransplantation of the kidney in tuberculosis]. / Autotransplantatsiia porazhennoi tuberkulezom pochki.

Autotransplantation of the left kidney into the iliac zone was fulfilled. A direct pelvic-vesical anastomosis was made for total tuberculosis of the ureter, which resulted in perfect clinical recovery. The patient was reexamined 6 months later and found to be practically healthy. On the basis of the absence of the vesical-pelvic reflux in the autotransplanted kidney the authors propose to refuse of the intestinal plasty of the ureter in favour of the vesical-pelvic (pelvic-vesical) anastomosis.