[Polyoxidonium in the treatment of calculous pyelonephritis].

Efficacy of polyoxidonium was studied in combined therapy of urolithiasis complicated with secondary pyelonephritis. Of 60 patients with secondary pyelonephritis in urolithiasis, 30 received adjuvant polyoxidonium. Phospholipids and cholesterol in cytomembranes were defined with thin-layer chromatography. Humoral immunity was evaluated by the levels of IgA, IgM, IgG, hemolytic activity of the compliment system, the level of circulating immune complexes, activity of lysozyme. Concentrations of IL-1beta, TNF, IL-4, IL-6 were also estimated. Subpopulations of immunocompetent cells were tested on flow cytofluorimeter by immunofluorescence with monoclonal antibodies. Phagocytic component of the immune system was assessed by phagocytic activity of neutrophils, phagocytic count, NBT test. The trial demonstrates that polyoxidonium has a positive action on the disease course, an antiinflammatory, immunomodulating properties, suppresses peroxidation, promotes recovery of structural-functional characteristics of cellular membranes in patients with urolithiasis and secondary pyelonephritis. Polyoxidonium is recommended in secondary pyelonephritis and urolithiasis as adjuvant to basic therapy for anti-inflammatory, detoxication and immunomodulating effect.

[Membrane-destabilizing processes as the universal basis of inflammation]. / Membranodestabiliziruiushchie protsessy kak universal'naia osnova vospaleniia.

It is established that active pyelonephritis and operative stress are accompanied with structural and functional changes in erythrocytic membranes: cholesterol and its ethers rose in quantity as well as difficulty oxidized phospholipids, cation adenosine triphosphatase activity changed. Being nonspecific, these changes seemed more pronounced in the active phase of chronic pyelonephritis. Minor structural rearrangement of membrane lipids in surgical patients indicated uneventful postoperative period. It is suggested that bacterial inflammation in the kidneys and urinary tracts may be related to the above shifts. The adjuvant use of dimephosphone produced a clear-cut membrane-stabilizing effect clinically reflected by reduced inflammation and improved renal function.

[Autogenous infections in the development of postoperative complications]. / Znachenie autogennogo infitsirovaniia v razvitii posleoperatsionnykh oslozhnenii.

The authors studied the mechanisms of bacterial dissemination in operative wounds in patients after various surgical interventions. It was demonstrated in experiments that during adaptation of the organism to the operative stress, autobacteria enter the blood from the intestinal reservoir and are eliminated through the urinary tract and wound surfaces, if foci of mechanical or toxic destruction exist the autobacteria precipitate in the affected tissues and participate directly in the reparative processes. On the basis of the obtained data it is suggested that the phenomenon of activation and persistence of endogenous microflora exists as one of the syndromes of adaptation of man to the aggression factor, which is aimed at revealing and removing the foci of tissue destruction developing as the result of exposure to the effect of the stress.

[Asymptomatic bacteriuria as the manifestation of a syndrome of the activation and persistence of endogenous microflora in dynamic human adaptation to stress]. / Bessimptomnaia bakteriuriia kak proiavlenie sindroma aktivatsii i persistentsii éndogennoi mikroflory v dinamike adaptatsii cheloveka k stressu.

The analysis has been performed of the mechanisms underlying the origin of asymptomatic bacteriuria as an adaptive reaction in response to surgical aggression. The experiments proved penetration of autobacteria from the intestine to blood channel and organic structures of the animals in the course of adaptation to an operative trauma and consequent elimination of the bacteria from the body. It was observed that endogenic microflora participates in regeneration of macroorganism structures which have lost their morphofunctional integrity due to mechanic and toxic aggression. It is suggested that activation and persistence of endogenic microflora may arise to identify and abolish foci of aseptic destruction during the aggression in adaptation to stress.

[The indices of cell membrane destabilization in urolithiasis patients]. / Pokazateli destabilizatsii kletochnykh membran u bol'nykh mochekamennoi bolezn'iu.

The paper gives the results of a clinical and biochemical study of 165 patients with urolithiasis and 46 healthy persons. Their urinary samples and renal biopsy specimens were analysed to assess the structural and functional status of nephron cell membranes. In urolithiasis patients, the urine was found to contain a great quantities of emulsified lipids enriched in toxic phospholipid and cholesterol metabolism products; renal tissue cytomembranes in the patients were depleted of phospholipids, free cholesterol and enriched in phospholipid lysoforms and cholesterol esters. Lipid phase destabilization of nephron epithelial membranes was shown to be pathogenetically associated with concrement formation. The examination of emulsified urinary lipids is an objective tool of renal tissue crystallization activity and may be recommended for the early diagnosis of urolithiasis, as well as an indicator of membrane-stabilizing therapy efficiency.

[The enzyme function of cationic transmembrane transport and its relationship to the homeostatic indices of patients with chronic pyelonephritis]. / Funktsional'noe sostoianie fermentov kationnogo transmembrannogo transporta i ikh vzaimosviaz' s nekotorymi pokazateliami gomeostaza u bol'nykh khronicheskim pielonefritom.

The paper examines the relationship between the clinical manifestations of pyelonephritis and the functional activity of enzymes of cation transmembrane erythrocyte transport (Mg(2+)-, N(+)-K(+)-, Ca(2+)-ATPases). An individual analysis ascertained that the patients who showed a low Ca(2+)-ATPase activity had marked signs of inflammation in the body, as evidenced by ESR, seromucoid and fibrinogen concentrations. These patients had more significantly depressed immune defense mechanisms as reflected by the levels of immunoglobulins, T-lymphocytes, complement, the neutrophil phagocytosis, and urinary IgA concentrations). Variations were also found in examining the excretion of a number of metabolites. There was a substantial decrease in urea, creatinine, titrated acid, phosphorus excretions in patients with deficient Ca(2+)-ATPase activity than in those with its high activity. It was concluded that there was a relationship between some clinical manifestations of pyelonephritis and the functional activity of enzymes of cation transmembrane transport. To treat metabolic disorders, membrane-protective agents are recommended to include into combined therapy.

[The treatment of coralliform nephrolithiasis]. / Lechenie korallovidnogo nefrolitiaza.

A total of 184 patients with dendritic nephrolithiasis (74.5% females and 25.5% males) were under study. It was established that in more than half of them the disease developed from the infectious inflammation of the urinary tract. Based on the findings, the authors supposed that in these patients the initial instability of cellular membranes was associated with a decrease in nonspecific resistance which was unfavourably complicated by infection of the urinary tracts and the formation of calcium phosphate calculus. As the presence of friable (low-contrast) calculi in the state of growth is accompanied by a severe inflammation, a continuous nonoperative treatment is mandatory. When the growth of the calculus is stopped and confirmed by its high-contrast dense X-ray shadow and the signs of inflammation ceased the authors insisted on the conduction of the 3-4-week inpatient preoperative management. The latter should include the administration of wide-range antibiotics, drugs for potentiation of nonspecific resistance and the complex of vitamins. Subcortical pyelolithotomy with partial nephrotomy is a method of choice in case of a "dry kidney". An average postoperative bedtime comprised 22.3 days.

[Shifts in the blood coagulation during adenomectomy of the prostate]. / Gemokoaguliatsionnye sdvigi pri adenoméktomii predstatel'noi zhelezy.

Hemocoagulation was studied in 116 patients with prostatic adenoma, stage II, before and 1, 4-7, 8-10 and 11-15 days after surgical intervention. Out of 77 patients exposed to routine adenomectomy, 55 persons were treated 12-14 days prior the surgery with therapeutic dosages of a vitamin A, E, C, P complex. After the operation they were given nicotinic acid in presence of the double load of vitamins A and E. Out of 39 persons exposed to urgent adenomectomy 19 patients were administered the double dosages of the same vitamins before the operation. The rest of the both groups were postsurgically given acetylsalicylic acid instead of vitamins. It was stated that the aforementioned vitamin therapy significantly decreased postsurgical blood coagulation disorders (in those who were prepared for the operation beforehand it happened before adenomectomy), improved the clinical course and outcomes of the postsurgical period. Presurgical investigations reveal an accelerated intravascular coagulation and mild manifestations of the DIC syndrome in patients with prostatic adenoma. After the operation the syndrome manifestations increase but rarely develop into stages II and III that are usually accompanied by consumption coagulopathy. To follow the syndrome progression one could use only 5 out of 13 tests defined by the authors: activated time of recalcification, prothrombin index, fibrinolytic activity, products of fibrin degradation and an ethanol test.