Email this article Pathological anatomy of reparative processes in the resected kidney treated with α-tocopherol acetate in experiment
- Authors: Shormanov I.S.1, Los M.S.2, Shormanova N.S.1
-
Affiliations:
- Yaroslavl State Medical University
- Yaroslavl Regional Clinical Hospital
- Issue: Vol 8, No 3 (2018)
- Pages: 44-52
- Section: Articles
- URL: https://journals.rcsi.science/uroved/article/view/10462
- DOI: https://doi.org/10.17816/uroved8344-52
- ID: 10462
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Abstract
Violation of the integrity of the kidney parenchyma during organ-preserving surgery is always accompanied by functional impairment in that part of the organ. This is due to mechanical damage to the nephron and the development of aseptic necrosis in the area of the resection, followed by development of an ischemic zone that expands during the repair process due to disrupted parenchymal cell metabolism and pressure from regenerating connective tissue.
Objective. To investigate the effect of α-tocopherol acetate on repair processes in the kidney parenchyma after an organ-preserving operation in a rat model.
Materials and methods. An experimental study was performed on 60 white laboratory rats that underwent resection of the lower pole of the left kidney. Postoperatively, a study group (n = 30) underwent intramuscular injections of a 10% α-tocopherol acetate oil solution, 0.2 ml 2 times a day for 5 days. A control group (n = 30) were left untreated.
Results. Compared with the control group, animals in the study group had a narrower zone of total necrosis and less pronounced inflammation and vascular stasis on days 7, 14, and 28 after the operation.
Conclusion. Use of the natural antioxidant α-tocopherol acetate in the postoperative period of organ-preserving kidney surgery may accelerate reparative processes in the damaged parenchyma.
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##article.viewOnOriginalSite##About the authors
Igor S. Shormanov
Yaroslavl State Medical University
Author for correspondence.
Email: i-s-shormanov@yandex.ru
Doctor of Medical Science, Professor, Head of the Department of Urology and Nephrology
Russian Federation, YaroslavlMarina S. Los
Yaroslavl Regional Clinical Hospital
Email: 922099@mail.ru
Candidate of Medical Science, Urologist
Russian Federation, YaroslavlNatalia S. Shormanova
Yaroslavl State Medical University
Email: 922099@mail.ru
Candidate of Medical Sciences, Assistant, Department of Pathological Anatomy
Russian Federation, YaroslavlReferences
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Fig. 1. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 7. Hematoxylin and eosin stain, ×200. a: Necrosis of all tissue components of the kidney and hemorrhage in the glomerular capillary loops. b: Hemorrhagic infiltrate of external areas in the necrotic zone. с: Hemorrhagic infiltrate of external areas in the necrotic zone, with hemorrhages in the stroma of the destroyed renal parenchyma
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Fig. 2. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 7. Hematoxylin and eosin stain, ×200. The border between the necrotic and intact renal parenchyma is populated mainly by polynuclear and a very few mononuclear leucocytes with no signs of fibrillogenesis
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Fig. 3. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 7. Hematoxylin and eosin stain, ×200. a: Micro abscess in the necrotic part of the kidney; the surrounding tissue is impregnated with blood. b, c: A microabscess is adjacent to dystrophic but viable renal parenchyma. There is no hemorrhage around the microabscess
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Fig. 4. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 7. ×200. a: Pronounced congestion and edema of the medullary stroma. Hematoxylin and eosin stain. b: Impaired arterial tone of medium cortical arteries. Hart elastin stain. c: Hemorrhage in the stroma and hydropic degeneration of tubular epithelial cells. Hematoxylin and eosin
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Fig. 5. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 7. ×200. a: Hydropic degeneration and necrosis of tubular epithelial cells with granular casts in the tubular lumen, and a leucocyte infiltration in the stroma. Hematoxylin and eosin stain. b: Hydropic degeneration and necrosis of tubular epithelial cells and in the collectro tubule with granular casts in the tubular lumen, a leucocyte infiltration in the stroma. Hematoxylin and eosin stain. c: Glycogen breakdown in the tubular epithelium. Periodic acid–Schiff stain
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Fig. 6. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 14. Hematoxylin and eosin stain. Morphonuclear leukocyte infiltration and young fibroblasts and fibrillar structures on the border between the necrotic and intact renal parenchyma. Magnification: а, b ×200; c ×400
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Fig. 7. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 14. Developing capsule with fibroblasts, fiber structures, and capillaries around a microabscess. Magnification: а ×200; b, c ×400
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Fig. 8. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 14. Hematoxylin and eosin stain, ×200. a: Pronounced congestion and stromal edema. b, c: Hemorrhage in cortical tissue, with hemosiderin deposition around hemorrhages and among accumulations of blood
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Fig. 9. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 14. Hematoxylin and eosin stain. a: Granular and hydropic degeneration of tubular epithelial cells and hemosiderin deposition in the stroma. ×200. b: Hydropic degeneration and necrosis of individual tubular epithelial cells with granular casts in the tubular lumen. ×200. c: Granular and hydropic degeneration of tubular epithelial cells and hemosiderosis of the stroma. ×400
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Fig. 10. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 28. Hematoxylin and eosin stain. Granulation tissue in the necrotic area, with scattered hemosiderin deposition. Magnification: а ×200; b, c ×400
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Fig. 11. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 28. a, b: Substitution of necrotic tissue by loose hydropic granular tissue enriched with vessels and thin fibrils, with hemosiderin deposition scattered through the granulation tissue. Hematoxylin and eosin stain. с: Overlapping reticular fibers in the granulation tissue. Periodic acid–Schiff stain. Magnification: а ×400; b, c ×200
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Fig. 12. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 28. ×200. a: Thin, loose collagen fibers where granulation tissue has replaced necrotic tissue. Masson stain. b, c: Encapsulation and organization of a microabscess. Hematoxylin and eosin stain
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Fig. 13. Kidney parenchyma in the resection zone in rats in the control group on postoperative day 28. Hematoxylin and eosin stain. a: Encapsulation and penetration of a microhematoma by immature connective tissue, with resorption of blood elements. ×200. b: Granular degeneration of tubular epithelial cells. ×200. c: Tubular epithelium, with large cells with bright homogenous cytoplasm in some tubules. ×400
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Fig. 14. Kidney parenchyma in the resection zone in rats in the α-tocopherol acetate-treated group on postoperative day 7. Hematoxylin and eosin stain, ×200. a: Necrosis of tubules under an intact stroma and hemorrhagic necrosis of a glomerulus. b, c: Necrosis of tubules under an intact stroma and glomerulus, with a neutrophil and mononuclear leukocyte infiltrate bordering the necrotic area
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Fig. 15. Kidney parenchyma in the resection zone of in rats in the α-tocopherol acetate-treated group on postoperative day 7. Hematoxylin and eosin stain, ×200. a: Hemorrhages with initial signs of reactive inflammation and hemosiderin deposition. b: Casts in tubular lumens. c: Hydropic degeneration and necrosis of tubular epithelial cells
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Fig. 16. Kidney parenchyma in (a, b) and above (c) the resection zone in rats in the α-tocopherol acetate-treated group on postoperative day 14. Hematoxylin and eosin stain. a: Resorption of necrotic tissues and hemosiderin deposition. ×200. b: Resorption of necrotic detritus with substitution by granulation tissue. ×400. c: Encapsulation and organization of a hematoma. ×200
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Fig. 17. Kidney parenchyma in the resection zone in rats in the α-tocopherol acetate-treated group on postoperative day 28. Hematoxylin and eosin stain. ×200. a: Substitution of necrotic detritus with fairly mature connective tissue containing hemosiderin. b: Deposition of lime in regenerating connective tissue. c: Cellular and fiber structure of regenerating connective tissue
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Fig. 18. Kidney parenchyma in (a, b) and above (c) the resection zone in rats of the α-tocopherol acetate-treated group on postoperative day 28. a: Collagen frame of regenerating connective tissue. Masson stain. ×200. b: Tubular epithelial lining including large cells with eosinophilic cytoplasm. Hematoxylin and eosin stain, ×400. c: Increased glycogen levels in the tubular epithelium. Periodic acid–Schiff stain, ×200
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