[Percutaneous surgery of diseases of the kidneys and urinary tracts].

Percutaneous interventions for diseases of the kidneys and upper urinary tracts (UUT) were fulfilled in 1254 patients. In renal cysts puncture, evacuation of the content and sclerotherapy were fulfilled. Repeated punctures of the cyst were fulfilled in 20, laparoscopic excision of it was fulfilled in 16 patients. In 499 patients with cholelithiasis 427 percutaneous nephrolitholapaxy and 87 extractions of the stone without its fragmentation were fulfilled. Percutaneous treatment of cholelithiasis by monotherapy was effective in 89.8% of the patients, in 10% of the patients distant lithotripsy was performed for residual stones. Good results of endoscopic correction of UUT strictures were obtained in 85.9% of the patients, unsatisfactory results--in 14.1%. Percutaneous interventions for foreign bodies in UUT and tumors of the pelvis were successful in all observations.

[Percutaneous nephrolithotripsy in the concrements of solitary and allotransplanted kidney].

Our 10-year studies (2001-2010) were devoted to assessment of efficacy of percutaneous nephrolithotripsy (PNL) in the treatment of nephroliths of the solitary and allotransplanted kidney. PNL was made in 16 patients with large or coral calculi of the solitary and allotransplanted kidney. Of them, 10 patients had solitary kidney, 2 patients had nonfunctioning contralateral kidney, 4 patients - transplanted cadaver kidney. The age of the patients varied from 26 to 74 years (mean age 46.5 +/- 14.6 years), 10 (62.5%) males, 6 (37.5%) females. Mean size of the calculi was 28.6 +/- 5.7 mm. Single pelvic calculi occurred in 11 patients, multiple - in 2, coral concrements were detected in 3 patients. Five patients had recurrent concrements after extracorporeal lithotripsy, PNL and pyelolithotomy. Serious intraoperative complications were absent. Postoperative fever occurred in 3 (18.7%) patients. Hemoglobin fall under 80-90 g/l demanding hemotransfusion was seen in 4 patients. Lumbotomy because of postoperative complications was not performed. PNL as monotherapy was effective in 12 (75%) of 16 patients. Four patients (25%) had residual stones which were exposed to extracorporeal lithotripsy. Dynamic scintigraphy showed normalization of urodynamics of the upper urinary tract and improvement of renal function. Thus, PNL is a low-invasive and effective surgical treatment of patients with nephroliths of the single and allotransplanted kidney.

[Characteristics of temporary organization of the bronchopulmonary pattern in healthy persons and in patients with bronchial asthma]. / Osobennosti vremennoi organizatsii bronkhopul'monarnogo patterna u zdorovykh i bol'nykh bronkhial'noi astomoi.

It has been shown by periodographic computer analysis that ultradian rhythms of all examined parameters (bronchial resistance, inhalation, exhalation and breathing cycle duration, inspiration activity index, pneumographic amplitude, inhalation rate) of bronchopulmonary pattern in asthmatics and normal subjects exhibit latent periodicity, with prevailing oscillations of about 60 sec. during spontaneous breathing or under exposures. changing bronchial potency. Slow-wave components form very complex poly-harmonical temporal structure with specific organization during air breathing and response to challenge tests. Bronchospasm provoked by inhalation of acetylcholine produced an abrupt decrease of the number of periodical ultradian components (or even total disappearance of oscillations) and the development of a rigid hypersynchronic temporal structure on the basis of the hypersynchronized ultradien fluctiations. The principal factors of this new system may be changes of airway resistance. Analysis of our data suggests that the phenomenon of bronchial hyper-reactivity may be associated with a disturbance in temporal organization of the cardiobronchopulmonary pattern. Development of temporal disorganization may have some pathogenetic stages such as hypersynchronization, disrhythmy, appearance of a rigid temporal structure and bronchospasm as a clinical result.

[Circadian organization of the indices of external respiration in bronchial asthma patients]. / Tsirkadnaia organizatsiia pokazatelei funktsii vneshnego dykhaniia u bol'nykh bronkhial'noi astmoi.

Circadian rhythms of external respiration function (ERF) and body function (BF) were studied in 20 patients with mild bronchial asthma, 20 patients with bronchial asthma of medium gravity and in 14 healthy subjects. Circadian rhythms of the medium-group parameters of ERF were shown to be statistically insignificant, whereas individual circadian chronograms demonstrated circadian rhythms for all the patients with BA and healthy subjects. Essential differences were found in the organization of the temporary structure of circadian rhythms of ERF in BA patients and healthy subjects. It was discovered that in BA patients, the maximal pathological alterations develop within the period from the midnight to 8 a. m., whereas the minimal disorders of ERF are recorded within the period from the noon to 8 p. m. It is suggested that deterioration of bronchial patency which brings about the development of obstruction in BA patients is the result of hypersynchronization and increased amplitude of the circadian rhythms of those parameters of ERF which determine the bronchial patency.