[The treatment procedure and medical rehabilitation of children with the nephrotic form of glomerulonephritis]. / Taktika lecheniia i meditsinskaia reabilitatsiia detei s nefroticheskoi formoi glomerulonefrita.

The article deals with the analysis of the results of radionuclide studies in 624 children with the nephrotic form of glomerulonephritis according to the effect of pathogenetic therapy in the immediate and late-term periods. The authors determined the values characterizing the renal hemodynamics and the functional and metabolic condition of the kidneys and allowing the probable outcome of the disease to be appraised. The severity of the functional disorders in the period of marked clinical manifestations of glomerulo-nephritis and the changes of the values during treatment allows the tactics of the therapeutic measures to be determined. The persistence of renal hemodynamic disorders in the follow-up of patients with a complete clinico-laboratory remission is shown, which dictates the necessity for increasing the time of medical rehabilitation in the nephrotic form of glomerulonephritis in children.

[HB viral infection and the nephrotic syndrome]. / Hb-virusnaia infektsiia i nefroticheskii sindrom.

Development, course and treatment of glomerulonephritis in comparison with other nephropathies was studied in 295 Hb-carriers with the nephrotic syndrome. Results of quantitative content of Hb-antigens in the blood serum and urine and nephrobiopsy materials were evaluated to show the etiopathogenetic role of Hb-viral infection in the development of glomerulonephritis. Four groups of Hb-carriers of the nephrotic syndrome were studied depending on hepatitis B markers in the blood serum. Treatment results are described in this category of patients.

[The morphofunctional characteristics of the blood lymphocytes in steroid-sensitive and steroid-resistant glomerulonephritis]. / Morfofunktsional'nye osobennosti limfotsitov krovi pri steroidchuvstvitel'nom i steroidrezistentnom glomerulonefrite.

Morphofunctional properties of the lymphocyte suspension of patients susceptible and resistant to glucocorticoids in nephrotic form of glomerulonephritis were studied. Ultrastructural study of lymphocytes was performed as well as immune tests (the determination of lymphocyte glucocorticoid receptors number, proliferative activity of mononuclears, HIA genotypes) in 216 children. Morphofunctional insufficiency of the patient lymphocytes as compared to that in donors was established. A higher morphologic variety, functional sufficiency of lymphocytes, a higher number of glucocorticoid receptors and a preferable HIA genotype were found in the hormone-susceptible patients. Lymphocytes of hormone-resistant patients were characterized by a high activity of RNA-synthesizing apparatus, the presence of damaged organelles, low number of glucocorticoid receptors and by the failure of proliferative response to the dexamethasone test. These differences allow the differential approach to glucocorticoid therapy.

[A mathematical model for predicting the efficacy of glucocorticoid therapy of glomerulonephritis]. / Matematicheskaia model' prognozirovaniia éffektivnosti gliukokortikoidnoi terapii glomerulonefrita.

A mathematical model is proposed for prediction of the efficacy of glucocorticoid therapy developed on the basis of the Bayes theorem and successive Wald's analysis. The model uses the retrospective values of the results of radioligand determination of the number of glucocorticoid receptor of lymphocytes and static renal scintigraphy. By means of the blind method the informative value of the mathematical model to predict the inefficacy of glucocorticoid therapy in nephrotic glomerulonephritis was 96%. A nomogram was developed.

[Determination of the sensitivity to glucocorticoids in vitro]. / Opredelenie chuvstvitel'nosti k gliukokortikoidam in vitro.

A modified method for the determination of glucocorticoid receptors in human lymphocytes is suggested. The principal distinction of the method is standardization by the lymphocyte count in a sample (1 mln) and the labeled hormone concentration. The modification saves time and money, limits the range of the data variations, and makes use of a lesser volume of blood. Examinations of 70 children aged 4 to 15 suffering from the nephrotic form of glomerulonephritis have made it possible to distinguish two groups of patients: with relatively high values of specific binding X = 6820.1 +/- 530.0 (n = 30, p = 0.95, t = 2.04), this corresponding to a clinical form of hormone-sensitive glomerulonephritis, and with relatively low values of specific binding X = 1815.2 +/- 302.8 (n = 40, p = 0.95, t = 1.96), that corresponds to hormone-resistant glomerulonephritis. Dynamic studies have not shown any statistically significant changes in the specific binding values. These results permit regarding the specific binding value as a prognostic criterion in the assessment of corticosteroid therapy; this allows a wide employment of the described method in practical nephrology.

[Diagnostic possibilities of static gamma-scintigraphy using 99mTc pyrophosphate and Tc 99m phosphate in children with glomerulo nephritis]. / Diagnosticheskie vozmozhnosti staticheskoi gammastsintigrafii s 99mTcppirofosfatom i 99mTc-fosfonom pri glomerulonefrite u detei.

Children with nephrotic glomerulonephritis were examined for incorporation of 99mTc-pyrophosphate and 99mTc-phosphone. The relationship was discovered between the accumulation of the radiopharmaceutical drug and the sensitivity to glucocorticoids used in the pathogenetic treatment. Accumulation of the drug in the course of the treatment documents the presence of complete, partial remission or the disease activity. It is recommended that static gammascintigraphy should be carried out for early assessment of the efficacy of the treatment and its correction.