Konjenital obstrüktif üropatide üreter duvarındaki histopatolojik değişiklikler
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Tarih
2007
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Ratlarda deneysel mesane hipoplazisi veya agenezisi sonucu meydana gelen konjenital obstrüktif üropatide üreter duvarındaki histopatolojik degisiklikleri incelemektir. Materyal ve Metod: Çalısmamızda 17 adet disi rat ve bunlardan elde edilen 29 fetüs kullanıldı. Annelerine gebeliklerinde müdahale yapılmayan, üriner sistem anomalisi gelismeyen fetüsler Grup 1'i olusturdu (n= 10). Annelerine gebeliklerinin 6.-9. günleri arası intraperitoneal 2ml. SF verilen, üriner sistem anomalisi gelismeyen fetüsler Grup 2'yi olusturdu (n= 10). Annelerine gebeliklerinin 6.-9. günleri arası 2ml. SF içinde sulandırılan 2mg/kg adriamisin intraperitoneal olarak verilen, üriner sistem anomalisi gelisen fetüsler Grup 3'ü olusturdu (n= 9). Tüm gruplardaki fetüslerden alınan kesitler Tripple ile histokimyasal, Cytokeratin-20 ve SMA ile de immünohistokimyasal olarak boyandı. Tripple ile üreter duvarındaki kas ve bag dokusu ayrımı yapıldı. Cytokeratin-20 ile ürotelyum gösterildi. SMA ile üreter duvarındaki kas tabakası boyandı. Sag üreter 1/3 orta kesimine denk gelen kesitlerde üreter lümen alanı, üreter duvar kalınlıgı, üreter epitel kalınlıgı ve üreter kas tabakası kalınlıkları mikroskopik olarak ölçüldü. Bulgular: 18 anomalili fetüsün 9'unda böbrek degerlendirilemedi. 9 tanesinde üreterohidronefroz saptandı. Üreter duvarında kollajen proliferasyonu ve fibrozis tespit edilmedi. Böbrek olusan 9 anomalili fetüsün 7'sinde mesane agenezisi, 2'sinde mesane hipoplazisi tespit edildi. Grup 1'i olusturan fetüs kesitlerinde ortalama üreter lümen alanı 23733.79 + 10079.76 ?m², üreter duvar kalınlıgı 61.27 + 8.39 ?m, üreter kas tabakası kalınlıgı 45.76 + 8.94 ?m ve üreter epitel kalınlıgı 17.45 + 3.84 ?m ölçüldü. Grup 2'yi olusturan fetüs kesitlerinde ortalama üreter lümen alanı 24286.94 + 5651.20 ?m², üreter duvar kalınlıgı 61.83 + 4.70 ?m, üreter kas tabakası kalınlıgı 45.44 + 5.08 ?m ve üreter epitel kalınlıgı 17.30 + 2.11 ?m ölçüldü. Grup 3'ü olusturan fetüs kesitlerinde ortalama üreter lümen alanı 50788.30 + 32236.92 ?m² , üreter duvar kalınlıgı 12.48 + 3.60 ?m , üreter kas tabakası kalınlıgı 7.08 + 2.99 ?m ve üreter epitel kalınlıgı 5.39 + 1.23 ?m ölçüldü. Grup 1 ve Grup 2 karsılastırıldıgında anlamlı fark bulunamadı (P>0.05). Grup 3, Grup 1 ve Grup 2 ile karsılastırıldıgında istatistiksel olarak anlamlı fark saptandı ( p<0.05). Sonuç: Çalısmamızda konjenital üriner sistem obstrüksiyonu sonucunda üreter lümen alanında artıs, üreter kas tabakası kalınlıgı, üreter duvar kalınlıgı ve üreter epitel kalınlıgında incelme tespit edildi. Üreter duvarında kollajen proliferasyonu, fibrozis ve inflamatuar hücreler tespit edilmedi. Anahtar kelimeler: Konjenital obstrüktif üropati, adriamisin, üreter duvarı, üreter epiteli
Our aim is, to investigate histopathologic changes in ureter wall in congenital obstructive uropathy due to experimental bladder hypoplasia and agenesis in rats. Materials and methods: In our study we used 17 female rats and their 29 fetuses. During their mother?s pregnancy we did not do any interwention for Group 1, which had no urinary system anomaly. Group 2 was given 2 ml % 0.9 NaCl intraperitoneally on 6-9 th days of their mother?s pregnancy and had no urinary system anomaly. Group 3 was given 2 ml %0.9 NaCl + 2 mg/kg adriamisin intraperitoneally on 6-9 th days of their mother?s pregnancy and had urinary system anomaly. Cytokeratin-20 and -SMA were used for immunohistochemical examination and Tripple for histochemical examination in sections taken from all groups. The muscle and connective tissue in the ureteral wall was identified by Tripple. Ürothelium was showed with Cytkeratin-20. The tunica muscularis of ureter was dyed with -SMA. The diameter of ureter lumen, the wall thickness of ureter, the epithelial thickness of ureter, and the tunica muscularis of ureter were measured microscopically in the tissues taken from 1/3 middle of right ureter. Results: The kidneys could not be evaluated in 9 of 18 fetuses with anomaly in histopathologic examination. Hydroureteronephrosis was identified in 9 fetuses. Collagen proliferation and fibrosis were not identified in the ureter wall. The agenesis of urinary bladder was identified in 7 of 9 fetuses and hypoplasie in 2 of 9 fetuses, who had kidney. The mean diameter of ureter lumen was 23733.79+10079.76 ?m², the wall thickness of ureter 61.27+8.39 ?m, the tunica muscularis of ureter 45.76+8.94 ?m, and the epithelial thickness of ureter 17.45+3.84 ?m in Group 1. The mean diameter of ureter lumen was 24286.94+5651.20 ?m², the wall thickness of ureter 61.83+4.70 ?m, the tunica muscularis of ureter 45.44+5.08 ?m, and the epithelial thickness of ureter 17.30+2.11 ?m in Group 2. The mean diameter of ureter lumen was 50788.30+32236.92 ?m², the wall thickness of ureter 12.48+3.60 ?m, the tunica muscularis of ureter 7.08+2.99 ?m, and the epithelial thickness of ureter 5.39+1.23 ?m in Group 3. There was no significant difference between Group 1 and Group 2 in comparison ( P>0.05) There was significant difference in Group 3 compared with Group 1 and Group 2 ( p<0.05). Conclusion: In our study, it was found that the diameter of ureter lumen is increased and wall thickness of ureter, tunica muscularis of ureter, and epithelial thickness of ureter is decreased due to congenital ureteral obstruction. The collagen proliferaton, fibrosis, and inflamatuar cells were not identified in ureter wall. Keywords: Congenital obstructive uropathy, adriamycin, ureteral wall, ureteral epithelium
Our aim is, to investigate histopathologic changes in ureter wall in congenital obstructive uropathy due to experimental bladder hypoplasia and agenesis in rats. Materials and methods: In our study we used 17 female rats and their 29 fetuses. During their mother?s pregnancy we did not do any interwention for Group 1, which had no urinary system anomaly. Group 2 was given 2 ml % 0.9 NaCl intraperitoneally on 6-9 th days of their mother?s pregnancy and had no urinary system anomaly. Group 3 was given 2 ml %0.9 NaCl + 2 mg/kg adriamisin intraperitoneally on 6-9 th days of their mother?s pregnancy and had urinary system anomaly. Cytokeratin-20 and -SMA were used for immunohistochemical examination and Tripple for histochemical examination in sections taken from all groups. The muscle and connective tissue in the ureteral wall was identified by Tripple. Ürothelium was showed with Cytkeratin-20. The tunica muscularis of ureter was dyed with -SMA. The diameter of ureter lumen, the wall thickness of ureter, the epithelial thickness of ureter, and the tunica muscularis of ureter were measured microscopically in the tissues taken from 1/3 middle of right ureter. Results: The kidneys could not be evaluated in 9 of 18 fetuses with anomaly in histopathologic examination. Hydroureteronephrosis was identified in 9 fetuses. Collagen proliferation and fibrosis were not identified in the ureter wall. The agenesis of urinary bladder was identified in 7 of 9 fetuses and hypoplasie in 2 of 9 fetuses, who had kidney. The mean diameter of ureter lumen was 23733.79+10079.76 ?m², the wall thickness of ureter 61.27+8.39 ?m, the tunica muscularis of ureter 45.76+8.94 ?m, and the epithelial thickness of ureter 17.45+3.84 ?m in Group 1. The mean diameter of ureter lumen was 24286.94+5651.20 ?m², the wall thickness of ureter 61.83+4.70 ?m, the tunica muscularis of ureter 45.44+5.08 ?m, and the epithelial thickness of ureter 17.30+2.11 ?m in Group 2. The mean diameter of ureter lumen was 50788.30+32236.92 ?m², the wall thickness of ureter 12.48+3.60 ?m, the tunica muscularis of ureter 7.08+2.99 ?m, and the epithelial thickness of ureter 5.39+1.23 ?m in Group 3. There was no significant difference between Group 1 and Group 2 in comparison ( P>0.05) There was significant difference in Group 3 compared with Group 1 and Group 2 ( p<0.05). Conclusion: In our study, it was found that the diameter of ureter lumen is increased and wall thickness of ureter, tunica muscularis of ureter, and epithelial thickness of ureter is decreased due to congenital ureteral obstruction. The collagen proliferaton, fibrosis, and inflamatuar cells were not identified in ureter wall. Keywords: Congenital obstructive uropathy, adriamycin, ureteral wall, ureteral epithelium
Açıklama
Anahtar Kelimeler
Konjenital obstrüktif üropati, Adriamisin, Üreter duvarı, Üreter epiteli, Congenital obstructive uropathy, Adriamycin, Ureteral wall, Ureteral epithelium
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Scopus Q Değeri
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Künye
Gürbüzer, N. (2007). Konjenital obstrüktif üropatide üreter duvarındaki histopatolojik değişiklikler. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Çocuk Cerrahisi Anabilim Dalı, Konya.
