[Indirect electrochemical blood oxidation in the prophylaxis of suppurative-inflammatory complications after transurethral resection of the prostate]. / Nepriamoe élektrokhimicheskoe okislenie krovi v profilaktike gnoino-vospalitel'nykh oslozhnenii posle transuretral'noi rezektsii prostaty.

To investigate efficiency of indirect electrochemical blood oxidation in prophylaxis of infectious complications, 28 patients were treated with 0.06% hypochlorite solution (2 infusions, 2-3 days before TURP). These patients belonged to a high-risk group of infectious complications (80% of them had chronic prostatitis, 8 patients had bladder stones, 8 had undergone cystostomy). The results demonstrated that the complication rate in the above prepared patients fell four times as compared to the control group and the postoperati hospital stay was reduced by 3 days.

[Change in indicators of metabolism and kidney function in intact rats after parenteral administration of sodium hypochlorite]. / Izmenenie pokazatelei metabolizma i funktii pochek u intaktnykh krys posle parenteral'nogo vvedeniia gipokhlorita natriia.

The changes of kidney metabolism, function and enzymuria activity of nephron epithelium cells after 4 days of parenteral administration of sodium hypochlorite 0.02% and 0.06% solutions were investigated in the experiments on 15 intact non-inbred rats of 200-280 g body weight. It was revealed that sodium hypochlorite induced metabolic damage to the kidney similar to ischemic one. The 0.02 and 0.06% solutions of sodium hypochlorite administered parenterally produced no negative effect on renal function. There was no significant rise of enzymuria activity in experimental groups compared to the controls. Moreover, enzymuria of four from six nephron epithelium cell enzymes decreased significantly to day 5 of the experiment. Metabolic damage and enzymuria activity changes were more pronounced in rats given parenteral 0.06% solution of sodium hypochlorite.

[Morphofunctional characteristics of erythrocytes in extracorporeal efferent detoxication]. / Morfofunktsional'naia kharakteristika éritrotsitov pri ékstrakorporal'noi éfferentnoi detoksikatsii.

The erythrocyte morphology (scanning electronic microscope, the superficial erythrocyte charge, the lipid peroxidation rate and the blood viscosity were investigated in 78 patients, treated by use of hemodyalisis, hemosorbtion, plasmosorbtion and hyperbaric oxygenation to correct the chronic renal insufficiency and the purulent intoxication. The described erythrocyte changes reflect the features of definite kind of the efferent treatment and the program of its use, the individuality of the patient initial state. The efferent methods of treatment cause significant and mostly differently directed changes in the peripheral red blood. Morphologic and functional parameters of the erythrocytes appear to be important diagnostic criteria of the efficiency of the extracorporal methods of detoxication.

[Increase in structural-functional tolerance of kidney to ischemia upon parenteral administration of sodium hypochlorite in the pre-ischemic period]. / Povyshenie strukturo-funktsional'noi tolerantnosti pochek k ishemii pri parenteral'nom vvedenii gipokhlorita natriia v predyshemicheskom periode.

The opportunity of raising kidney structural and functional tolerance to ischemia with parenteral injections of 0.06% solution of sodium hypochlorite for 4 days in preischemia period was studied in experiment on 22 non-inbred rats of 200-280 g body weight. 90 minute ischemia was created by ligating the left and right kidney arteries, veins, ureters. Morphological and functional kidney data, enzymuria activity of nephron epithelium cells were registered, 80 and 33% of the rats survived 7 days after ischemia in the study and control groups, respectively. The control animals showed deterioration of the tubules function, high enzymuria. Thus, it is possible to raise kidney tolerance to ischemia by preischemic parenteral injection of sodium hypochlorite solution.

[Morphofunctional characteristics of erythrocytes in chronic kidney failure and purulent intoxication]. / Morfofunktsional'naia kharakteristika éritrotsitov pri khronicheskoi pochechnoi nedostatochnosti i gnoinoi intoksikatsii.

The morphology of blood erythrocytes was examined under a scanning electron microscope and erythrocyte surface charge, lipid peroxidation on erythrocyte membranes, and blood viscosity were studied in 213 urological patients with chronic renal insufficiency (CRI) and purulent intoxication (PI) of different severity. CRI and PI were characterized by morphofunctional changes in erythrocytes, which depended on the type and severity of intoxication. Changes in erythrocyte morphology in CRI and PI were paralleled by a decrease in their negative surface charge and activation of lipid peroxidation. These parameters can serve as diagnostic tests for evaluation of the severity of intoxication.

[Effects of sodium hypochlorite on the course of recovery of structural elements and functions of the kidneys in postischemic period]. / Vliianie gipokhlorita natriia na dinamiku vosstanovleniia strukturnykh élementov v funktsional'nykh sposobnostei pochek v postishemicheskom periode.

Kidney morphological structure, function and enzymuria were studied in experiment on 22 non-inbred rats of 200-280 g body weight with 90 min kidney ligature ischemia on day 3 and 7. In experimental group (11 rats) 1 ml 0.06% solution of sodium hypochlorite (SH) was injected intraperitoneally daily after kidney ischemic damage. 11 rats of the control group received 1 ml 0.89% SH solution in daily intraperitoneal injections. Morphological changes in renal structure, functional capacity of the kidneys, enzymuria on experimental day 3 and 7 were studied. It was revealed that SH injected in acute ischemic phase aggravated kidney cell damage. However, SH induced kidney reparative reaction on day 3. In the control group this reaction was registered only on day 7. It is suggested that SH may be an effective prophylactic modality against ischemic renal damage.

[Sodium hypochlorite in the treatment of bacteremic circulatory shock]. / Gipokhlorit natriia v lechenii infektsionno-toksicheskogo sosudistogo shoka.

17 patients with massive urinary infection and bacteriemic circulatory shock received a combined intensive treatment including indirect electrochemical blood oxidation (IEBO) with 0.06% solution of sodium hypochlorite (SHC). SHC intravenous infusions resulted in stabilization of arterial pressure within 24 hours. IEBO in the treatment of incipient bacteriemic shock improves prognosis.

[Occlusive factor in development of urolithiasis complications]. / Okkliuziruiushchii faktor v razvitii oslozhnenii mochekamennoi bolezni.

Causes and mechanisms of complications in urolithiasis are analysed with a focus on the role of occlusion of the urinary tracts in the onset of pyoseptic complications. Most severe of them is bacteriotoxic shock which is hard to treat and dangerous for essential body functions. The priority of the treatment must be reestablishment of urine passage. Additional tools of the treatment include wide-spectrum antibiotics, efferent detoxication, electrochemical blood oxidation, hyperbaric oxygenation, UV blood radiation.

[Effects of indirect electrochemical blood oxidation by sodium hypochlorite solution on the course on inflammatory process in the kidneys and urinary tract]. / Vliianie nepriamogo élektrokhimicheskogo okisleniia krovi rastvorom gipokhlorita natriia na techenie vospalitel'nogo protsessa v pochkakh i mochevykh putiakh.

The action of indirect electrochemical blood oxidation with 0.06% solution of sodium hypochlorite on kidney and urinary inflammation was studied in experiments on 60 non-inbred rat females of 200-250 g body weight. The animals were intravesically infected through the catheter with E. coli and Ps. aeruginosa. 3 days later, after histological verification of acute pyelonephritis, ureteritis, cystitis, the animals were injected intraperitoneally 1.0 and 2.0 ml daily of sodium hypochlorite solution (control animals) or 0.89% solution of sodium chloride. Though no reliable decrease of the bacterial contamination was achieved, histologically, there was a marked reduction in morphological signs of the inflammation in the kidneys, ureter and urinary bladder on the first day after beginning of electrochemical blood oxidation with solution of sodium hypochlorite in experimental groups. In experimental group rats morphological signs of urinary and renal inflammation for both infections disappeared on days 7 and 10, respectively. In the control animals morphological signs of the inflammation remained after 10 days. Moreover, purulent inflammation was registered in the controls infected with Ps. aeruginosa.

[The use of xidifon for the correction of phosphorus-calcium metabolism in patients in the terminal stage of chronic kidney failure who are on programmed hemodialysis]. / Primenenie ksidifona dlia korrektsii fosforno-kal'tsievogo obmena u bol'nykh s terminal'noi stadiei khronicheskoi pochechnoi nedostatochnosti, nakhodiashchikhsia na programmnom gemodialeze.

Correction of impaired phosphoric-calcium metabolism was performed in 15 hemodialysis patients with terminal chronic renal failure (TCRF). For this purpose a synthetic analogue of pyrophosphoric acid xidiphone produced in Russia was used (2% aqueous solution 1 tablespoon 3 times a day 0.5 h before meal for 2-3 months). Prior to and in the course of xidiphone treatment all the patients received calcium gluconate (1 g x 3 daily), polyvitamins, on-demand digoxine. Measurements of serum concentrations of urea, potassium, sodium, total calcium, alkaline phosphatase activity demonstrated xidiphone-related normalization of serum total calcium, serum activity of alkaline phosphatase, a mild rise of sodium. The results say in favor of using xidiphone in the TCRF patients.

[The dynamic level of beta 2-microglobulin, the basic lipid peroxidation indices and middle molecules in the blood and urine in patients with acute calculous pyelonephritis against a background of endovascular helium-neon laser therapy]. / Dinamika urovnia beta 2-mikroglobulina, osnovnykh pokazatelei perekisnogo okislennia lipidov, srednikh molekul v krovi i moche u bol'nykh ostrym kal'kuleznym pielonefritom na fone éndovaskuliarnoi gelii-neonovoi lazernoi terapii.

The authors present the effect of intravenous He-Ne laser therapy on the changes in beta 2-microglobulin, lipid peroxidation, middle-size molecules in the blood and urine of patients with acute calculous pyelonephritis. Endovascular He-Ne laser therapy was found an effective treatment of acute calculous pyelonephritis. The authors propose to combine hemosorption with endovascular He-Ne laser radiation.

[Beta 2-microglobulin kinetics during hemodialysis with different membranes]. / Kinetika beta 2-mikroglobulina vo vremia gemodializa s razlichnymi membranami.

Dialysers F6 (polysulphon membrane) and Altra Nova-170 (acetate cellulose-H membrane) were tested for effects on concentration of beta 2-microglobulin (beta-2 MG) in the course of hemodialysis. F6 produced a rise in beta-2 MG levels (50.0 +/- 7.7 to 59.2 +/- 9.5 mg/l). Altra Nova-170 induced no significant changes in these levels. Dialyser F6 seems to stimulate generation or release of beta-2 MG the input and output amounts of which indicate that the process may be confined to dialyser interior. On hemodialysis minute 15 a sharp fall in beta-2 MG concentrations was registered in the use of either device. This phenomenon resembles leukopenic effect of cellulose membranes. Hemodialysis kinetics of beta-2 MG is likely to depend on leukocyte activation.

[Blood viscosity and the erythrocyte charge in patients with chronic kidney failure and suppurative intoxication and during the correction of these conditions by hemosorption and hemodialysis]. / Viazkost' krovi i zariad éritrotstiov u bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu i gnoinoi intoksikatsiei i pri korrektsii étikh sostoianii gemosorbtsiei i gemodalizom.

Examinations of blood samples from healthy subjects and 16 patients suffering from chronic renal failure and purulent intoxication before and after hemodialysis and hemosorption showed changes in blood viscosity and red cell charges in the patients. Blood viscosity diminished following both hemodialysis and hemosorption, whereas red cell electric charge grew after hemodialysis, but fell after hemosorption. Correlations found between the viscosity, red cell charge and concentrations of urea and creatinine suggest a dependence of blood rheology and red cell surface electrostatic properties on azotemic intoxication. Thus, hemodialysis and hemosorption produce diverse effects on physiochemical characteristics of blood.

[The morphological characteristics of the erythrocytes during hemosorption in patients with chronic kidney failure and suppurative intoxication]. / Morfologicheskie osobennosti éritrotsitov pri gemosorbtsii u bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu i gnoinoi intoksikatsiei.

Red blood cells obtained shortly before and after a hemosorption session from 12 patients were studied in scanning electron microscope. The patients suffered from chronic renal failure and purulent intoxication consequent to urolithiasis and purulent pyelonephritis (10 cases), renal arteriosclerosis (1 case) and prostatic cancer (1 case). Before hemosorption number of discocytes measured 50.8%, while that of stomatocytes 37.3%. Spherocytes, echinocytes and knisocytes occurred in larger quantities. After hemosorption diskocytes amounted 67%, echinocytes and acanthocytes levels rose. The changes may be due to normalization of blood biochemistry after the hemosorption, and to sorbent effects on red cells.

[Bacterial toxic shock in urological diseases]. / Bakteriotoksicheskii shok pri urologicheskikh zabolevaniiakh.

It is a review of present-day and historical aspects of bacterial toxic shock arising in urological setting. It is noted that conditions of its onset are changing, therapeutic approaches undergo revision, critical care facilities are updated. Among the causes of this complication the authors single out endoscopic procedures, transurethral interventions in the presence of infectious process, hospital infection, long stay at hospital. Forty-eight cases of bacterial toxic shock are reviewed in relation to classification, causes of development, treatment, bacteriological evaluation.

[Hemoperfusion via cryopreserved tissue fragments of xenogeneic spleen in suppurative-septic states in urology]. / Gemoperfuziia cherez kriokonservirovannye fragmenty tkani ksenoselezenki pri gnoino-septicheskikh sostoianiiakh v urologii.

Hemoperfusion through cryopreserved fragments of porcine xenospleen tissue was used in combined treatment of 42 patients with pyoseptic urologic diseases: urosepsis, purulent intoxication due to acute pyelonephritis, pyoinflammatory scrotal and prostatic lesions (in 15, 19, 8 patients, respectively). Indications and contraindications are specified. Altogether 57 sessions were performed. Seventeen patients underwent the perfusion pre- and postoperatively, twenty-five in combination with chemotherapy. After the removal porcine spleen was dissected, treated with cryoprotective mixture (-196 degrees C) and placed into liquid nitrogen. One-year viability of the tissue retained in 82-93% of the samples. Duration of the hemoperfusion was 40-80 min, the rate--30-40 ml/min. Two-four columns with cryopreserved tissue were utilized which were alternately connected with the circuit. Heparinization reached 12,000-15,000 units. All the patients survived. Positive clinical and laboratory findings were obtained for 38 patients (90%). Urine and blood samples appeared sterile on day 7-12. The improvement of the severe condition of the patients is attributed to detoxication, immunostimulation and immunocorrective effects.

[The treatment of infectious-inflammatory urologic diseases and their complications by efferent detoxication methods]. / Lechenie infektsionno-vospalitel'nykh urologicheskikh zabolevanii i ikh oslozhnenii éfferentnymi metodami detoksikatsii.

This is an account of experience with extracorporeal detoxication techniques in 238 patients with urologic conditions who underwent 305 hemosorption (HS), 30 plasma sorption (PS) and 171 plasmapheresis (PA) sessions. Clinical and laboratory criteria are presented for employing an extracorporeal detoxication technique depending on predominance of suppurative septic or azotemic intoxication, and contraindications for HS, PS and PA. Absolute indications for these techniques were suppurative septic intoxication secondary to acute and chronic urologic inflammatory diseases, including septic shock, and acute renal failure. An emphasis is placed on the need for utilization of this therapy after urine flow recovery and drainage of all suppurative foci. An overview of mechanisms of different extracorporeal detoxication techniques showed them to share detoxifying and immunostimulating effects and improvement of blood rheology, renal and hepatic function. Application of the extracorporeal techniques reversed 84.4% of acute pyelonephritis, 61% of acute renal failure (without resorting to hemodialysis) and 65.4% of septic shock. This therapy was less efficient in patients with multiple organ failure. Good efficacy of xenogenic-spleen or splenocyte-suspension hemoperfusion was shown in patients with urosepsis.