Gecit Ilhan, Kavak Servet, Oguz Elif Kaval, Pirincci Necip, Günes Mustafa, Kara Mikail, Ceylan Kadir, Kaba Mehmet, Tanık Serhat
Department of Urology, Faculty of Medicine, Yuzuncu Yıl University, Van, Turkey.
Department of Biophysics, Faculty of Medicine, Yuzuncu Yıl University, Van, Turkey
Toxicol Ind Health. 2014 Oct;30(9):845-50. doi: 10.1177/0748233712462481. Epub 2012 Oct 24.
This study was designed to investigate whether exposure to short-term extracorporeal shock wave lithotripsy (ESWL) produces histologic changes or induces apoptosis in the kidney, adrenal glands or diaphragm muscle in rats. The effect of shock waves on the kidney of male Wistar rats (n = 12) was investigated in an experimental setting using a special ESWL device. Animals were killed at 72 h after the last ESWL, and the tissues were stained with an in situ Cell Death Detection Kit, Fluorescein. Microscopic examination was performed by fluorescent microscopy. Apoptotic cell deaths in the renal tissue were not observed in the control group under fluorescent microscopy. In the ESWL group, local apoptotic changes were observed in the kidney in the area where the shock wave was focused. The apoptotic cell deaths observed in the adrenal gland of the control group were similar to those observed in the ESWL groups, and apoptosis was occasionally observed around the capsular structure. Apoptotic cell deaths in the diaphragm muscle were infrequently observed in the control group. Apoptosis in the ESWL group was limited to the mesothelial cells. This study demonstrated that serious kidney, adrenal gland and diaphragm muscles damage occurred following ESWL, which necessitated the removal of the organ in the rat model. It is recognized that the ESWL complications related to the kidney, adrenal gland and diaphragm muscles are rare and may be managed conservatively.
本研究旨在调查短期体外冲击波碎石术（ESWL）是否会在大鼠的肾脏、肾上腺或膈肌中产生组织学变化或诱导细胞凋亡。使用一种特殊的ESWL设备，在实验环境中研究了冲击波对雄性Wistar大鼠（n = 12）肾脏的影响。在最后一次ESWL治疗72小时后处死动物，并用原位细胞死亡检测试剂盒（荧光素）对组织进行染色。通过荧光显微镜进行显微镜检查。在荧光显微镜下，对照组肾组织未观察到凋亡细胞死亡。在ESWL组中，在冲击波聚焦区域的肾脏中观察到局部凋亡变化。对照组肾上腺中观察到的凋亡细胞死亡与ESWL组相似，偶尔在包膜结构周围观察到凋亡。对照组中很少观察到膈肌中的凋亡细胞死亡。ESWL组的凋亡仅限于间皮细胞。本研究表明，ESWL后大鼠模型中出现了严重的肾脏、肾上腺和膈肌损伤，这需要切除器官。人们认识到，与肾脏、肾上腺和膈肌相关的ESWL并发症很少见，可能通过保守治疗处理。
