[Surgical treatment pf vasorenal hypertension complicated by renal failure]. / Khirurgicheskoe lechenie vazorenal'noi gipetenzii, oslozhnennoi pochechnoi nedostatochnost'iu.

28 patients with vasorenal hypertension complicated by renal failure were operated. 20, 7 and 1 patients were in the stages of compensation, subcompensation and decompensation, respectively. Nephrectomy, plastic reconstruction of renal artery, nephropexy, dilation of the renal artery were made. Validity of adrenalectomy is discussed. Good and satisfactory responses were observed in 50 and 35.7% of cases. 14.3% of the patients failed treatment. Poor effect was observed in long-term and severe arterial hypertension and late stages of renal insufficiency.

[Effects of antihypertensive therapy on renal function in nephrogenic hypertension]. / Vliianie gipotenzivnoi terapii na funktsiiu pochek pri nefrogennoi gipertenzii.

Radionuclide tracing was performed to study renal function before and after hypotensive therapy in 95 patients suffering from nephrogenic hypertension with renal failure. It is shown that if hypotensive therapy in such patients brings about a blood pressure fall more than 25% of the initial blood pressure, renal function declines, the suppression being especially evident in severe renal insufficiency.

[Ultrasonic diagnosis in selecting the treatment method for varicocele]. / Ul'trazvukovaia diagnostika v vybore metoda lecheniia varikotsele.

The paper deals with ultrasound diagnosis as a modality able to recognize indications either to surgical or endovascular treatment of varicocele. Forty-two patients aged 12-28 with varicocele degree I-III were examined using sector ultrasonic transducers (3.5,5 MHz) which visualized renal and internal testicular veins. Relevant ultrasonic and phlebographic findings were compared. The impossibility to predict outcomes of the endovascular treatment is attributed to the absence of primary information on the structure of the renotesticular portion of varicocele patients' venous bed. Ultrasonography can provide such information. The detection rate of multiple internal testicular veins and other renotesticular anomalies appears rather high.

[The function of the contralateral kidney in patients with nephrogenic arterial hypertension with unilateral involvement]. / Funktsional'noe sostoianie kontralateral'noi pochki u bol'nykh nefrogennoi arterial'noi gipertenziei pri odnostoronnem porazhenii.

The examination of 43 patients with unilateral lesions of the kidneys and their vessels was performed. The above condition was complicated by vasorenal (16 patients) or parenchymatous (27 patients) nephrogenic arterial hypertension. Mean arterial pressure (APm) was 143 +/- 12.4 mm Hg in mean duration of the disease 4.5 +/- 1.2 years. Mean age of the patients was 34.3 +/- 3.2 years. Dynamic renal scintigraphy determined glomerular filtration rate (GFR) using 99mTc-DTPA. Effective renal plasmic flow (ERPF) was measured with 131I-hippuran. 27 patients underwent acute captopril test with repeated renal scintigraphy. Angiography was used to evaluate plasma renin (PR) activity in renal veins. 1 year after various operations the patients were reexamined. By the value of diastolic pressure (DP), the above captopril test, changes in GFR and ERPF in the contralateral kidney and PR activity, the patients were divided into 3 groups. Group 1 of 13 patients had DP not higher than 90 mm Hg duration of the disease not more than 3 years. They responded to captopril test by AP decrease by 25-28%, PR activity increased 2.3 times. In the contralateral kidney GFR reduced by 7%, ERPF elevated by 15%. The renin coefficient reached 1.4-1.5. Group 2 of 22 patients had DP 95-100 mm Hg. They responded to captopril by APm 15% reduction, RP activity got 1.2-1.5 times higher, GFR in the contralateral kidney lowered by 10%, whereas ERPF rose by 10% Renin coefficient reached 1 or PR activity was higher in the contralateral kidney. Hypertension lasted in them 5 years. Group 3 patients (n = 8) had DP above 100 mg Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

[The possibility of predicting the hypotensive effect of the surgical treatment of nephrogenic hypertension]. / Vozmozhnost' prognozirovaniia gipotenzivnogo éffekta khirurgicheskogo lecheniia nefrogennoi gipertenzii.

An acute captopril test with a repeated dynamic renoscintigraphy was made in 27 patients with unilateral diseases of the kidneys complicated by nephrogenic hypertension. The above pharmacotest allows the hypotensive effect of operation to be prognosed by the dynamics of the average arterial pressure, plasma renin and blood aldosterone activity as well as by the dynamics of the rate of glomerular filtration and efficient renal plasma flow in the contralateral kidney.

[Diagnostic prospects of angiography in pyo-destructive processes in the kidney]. / Diagnosticheskie vozmozhnosti angiografii pri gnoino-destruktivnykh protsessakh v pochke.

The article is devoted to search for indications and more exact differential diagnostic criteria of angiographic methods of diagnosis of pyo-inflammatory diseases of the kidney. Of most informative value is the selective renal arteriography and pharmacophlebography which gave more exact differential diagnostic criteria.

[Indices of testicular endosecretory function and of the status of the hypophyseal-gonadal system in varicocele]. / Nekotorye pokazateli vnutrisekretornoi funktsii iaichka i sostoianiia gipofiz-gonadnoi sistemy pri varikotsele.

Testicular intrasecretory function and gonad-hypophyseal regulation were studied in 28 patients with the left-sided varicocele whose age varied from 11 to 36 years. Radioimmunoassay was used for the assessment of testosterone, estradiol, progesterone, follicle-stimulating (FS) and luteinizing (L) hormones and prolactin levels in the blood samples from femoral and internal testicular veins taken during endovascularization of varicocele. With regard to the age and manifestations of the secondary sexual signs the patients were divided into three groups. The first group (11-12-year-old) enrolled the patients with normal age-related levels of FS and L hormones in the presence of hyperprolactinemia. The positive testiculoperipheral gradient was revealed in 3 cases for estradiol and in 2 patients for testosterone and progesterone. The peripheral blood testosterone was normal in all the patients whereas estradiol and progesterone were decreased in 2 and 4 cases, respectively. All the patients of the second group (13-15-year-old) demonstrated an increase in testicular blood testosterone and estradiol as compared to their levels in the peripheral blood (1.46-1.8-fold and 1.3-7.1-fold, respectively). In 6 patients, this ratio was 1.65-2.33-fold higher. The levels of FS and L hormones were normal. In all cases hyperprolactinemia was observed. The third group (16-36-year-old) patients demonstrated a 1.4-3.1-fold gradient of testosterone in the testicular blood versus its levels in the peripheral blood. The authors defined 1.1-239-fold (mean, 8.95) estradiol gradients and 0-979-fold (mean, 2.5) progesterone gradients. In all cases but one, the levels of FS and L hormones were equal to the control.(ABSTRACT TRUNCATED AT 250 WORDS)

[A radionuclide study of the renal filtration fraction in nephrogenic hypertension]. / Radionuklidnoe issledovanie fil'tratsionnoi fraktsii pochek pri nefrogennoi gipertonii.

The effective renal plasma flow (ERPF), the rate of glomerular filtration and filtration fraction were investigated in 48 patients with nephrogenic hypertension (NH) using the method of dynamic renoscintigraphy with a double label (131I-hippuran and 99mTc-DTPA). The proposed method of noninvasive combined assessment of renal function was shown to be simple to perform and permitted the determination of a degree of involvement of the glomerular and tubular apparatus of the kidneys in NH. The comparison of renoscintigraphic and histomorphological results made it possible to determine renoscintigraphic criteria of glomerulo- and nephrosclerosis.

[Functional status of the right heart in patients with nephrogenic hypertension]. / Funktsional'noe sostoianie pravykh otdelov serdtsa u bol'nykh s nefrogennoi gipertenziei.

Marked hemodynamic disorders in the right heart were demonstrated in patients with nephrogenic arterial hypertension: they were high diastolic blood pressure and the right-ventricular hypodynamic syndrome, dependent on the duration of underlying disease and aortic diastolic blood pressure level.

[Endovascular electrosurgery of varicocele]. / Endovaskuliarnaia élektrokhirurgiia varikotsele.

A new method of treatment of varicocele is described consisting in the endovascular electrocoagulation of the internal testicular vein in order to interrupt reno-testicular reflux resulting from insufficiency of the internal testicular vein valves. The endovascular electrocoagulation of the internal testicular vein was fulfilled via either a retrograde or an antegrade access. The endovascular electrocoagulation of the internal testicular vein was made in 49 patients with a left-side varicocele. In 38 of them coagulation was performed via a retrograde access, in 11 patients an antegrade access was used. The method is less traumatic and possesses both a diagnostic and curative value.