[Treatment of stable dysuria in women]. / Lechenie stoikoi dizurii u zhenshchin.

The authors analyse treatment results for 88 women suffering from stable dysuria (SD). 44 of them with diagnosis "proliferative cystitis" underwent TUR of the bladder mucosa. The rest were treated conventionally. Biopsy of the bladder was made in all the patients. It is shown that mechanisms of SD development lies in that developing metaplasia of the squamous epithelium prevents close contacts between the surface cells leading to urine penetration into the submucous layer. This provokes frequent and painful micturition. The area of the bladder triangle contains vaginal epithelium (embryological) which changes according to the menstrual phases. Dysuria is more pronounced in the premenstrual period, i.e. in the period of marked desquamation of the squamous epithelial. Desquamation of the surface layer of metaplastic squamous epithelium cells and its thinning ease urine diffusion via intercellular space to the nerves and muscles of the bladder detrusor, thus deteriorating clinical symptoms. Thus, pain in full bladder results from functional failure of metaplastic multilayer squamous epithelium. To eradicate SD in such a situation, TUR of the bladder is recommended.

[A new sorbent for hemosorption]. / Novyi sorbent dlia gemosorbtsii.

SIAL, a new granulated white adsorbent, has been obtained. It is characterized by highly porous surface with hydrophilic-hydrophobic properties due to combined effects of the mineral matrix (aluminum oxide) and the coating (organosiloxane fluid) permitted for medical use. The detoxication properties of the adsorbent have been demonstrated in experimental hemosorption. It was shown to exert a moderate effect on the contact phase of blood clotting and on platelet aggregation characteristics.

[Wilms' tumor in adults]. / Opukhol' Vil'msa u vzroslykh.

4 rare cases are reported of adult Wilms' tumor in females aged 35-65. It had been developing subclinically for a long time and was detected at palpation or at abdominal ultrasonography. In the 35-year-old woman the weight of the removed tumor reached 3.5 kg. Wilms' tumor in the adults seems to run asymptomatically and, consequently, is likely to be diagnosed late.

[The use of plasmapheresis in treating urology patients]. / Ispol'zovanie plazmafereza v lechenii urologicheskikh bol'nykh.

The paper presents the results of plasmapheresis inclusion into a combined therapy of pyelonephritis. Out of 79 patients treated, 42 had urosepsis, 25 developed pyelonephritis in pregnancy, 12 had complicating chronic renal failure. Uroseptic patients were examined for hemostasis, the rest for immune status. There were symptoms of DIC syndrome in the former and immunity suppression in the latter. After the combined therapy with plasmapheresis, latent hypercoagulation and intoxication disappeared, uroseptic manifestations reduced. The above treatment of pregnancy pyelonephritis stopped inflammation, promoted activation of the immune system. In patients with chronic renal failure adjuvant plasmapheresis enhanced cellular and humoral immunity, neutrophil function, the number of middle-size molecules in the blood diminished. The latter improved renal function in decreasing uremia.

[The treatment of the disseminated intravascular coagulation syndrome in urosepsis patients]. / Lechenie sindroma disseminirovannogo vnutrisosudistogo svertyvaniia krovi u bol'nykh urosepsisom.

The hemostasis system has been assessed in 42 patients in the age range of 18 to 60 years with secondary urosepsis. All patients had been operated for upper urinary tract obstruction or suppurative destructive renal and retroperitoneal lesions. Hemostasis was examined before and after the operation using coagulation screen. Middle-molecular peptides were assayed in the patients before and after plasmapheresis. Revealed hemostatic disorders were treated with heparin, antibacterial agents and infusion of fresh frozen plasma. Plasmapheresis is indicated in patients who are unresponsive to antibacterial therapy and surgical drainage of suppurative lesions. Postoperative hemostatic disorders presented as both hypo- and hypercoagulation, with thrombinemia in most cases. The patients with urosepsis showed latent hypercoagulation phase of DIC. By removing acute phase proteins, plasmapheresis prevented fibrinolytic failure. Exfusion of small volumes of plasma did not affect antithrombin III levels and produced a coagulation-anticoagulation balance. Declining levels of middle-molecular peptides after plasmapheresis were indicative of detoxication, presenting as better clinical status and improvement of laboratory findings.

[Use of plasmapheresis in multimodality correction of hemostasis disorders in patients with calculous pyelonephritis]. / Plazmaferez v kompleksnoi korrektsii narushenii gemostaza u bol'nykh kal'kuleznym pielonefritom.

As many as 142 patients with calculous pyelonephritis were examined for the system of hemostasis. It is shown that pyelonephritis is characterized by hypercoagulation shifts according to the echitox test, by the high content of fibrinogen and its degradation products, thrombinemia, a decrease of the antithrombin III level, and by high heparin resistance of plasma. At the same time there was a reduction of fibrinolysis. Thirty-six patients with the most pronounced disorders of hemostasis underwent multimodality treatment including plasmapheresis which favoured an improvement of the patients' status. The body temperature declined, the signs of intoxication disappeared, and the well-being improved. Hypercoagulation tended to disappearance, whereas the content of fibrinogen and its degradation products decreased. The level of antithrombin III rose and plasma resistance to heparin disappeared. At the same time the characteristics of the paracoagulation tests identifying thrombinemia remained unchanged. No noticeable changes in fibrinolysis were recorded. It is suggested that plasmapheresis should be widely used in multimodality treatment of pyelonephritis.

[Microcirculatory and hemostatic disorders in calculous pyelonephritis patients]. / Narusheniia mikrotsirkuliatsii i gemostaza u bol'nykh kal'kuleznym pielonefritom.

The state of microcirculation and the system of hemostasis were studied over time in 52 patients with chronic calculous pyelonephritis. Investigations were performed before operation, after 2-4 days, 5-7 days and on discharge. The patients were divided into 2 groups: with chronic pyelonephritis in the phase of active inflammation and with chronic pyelonephritis in the phase of remission. Marked disorders in the system of hemostasis characterized by hyperfibrinogenemia, thrombinemia, a decrease in the heparincofactor plasma activity, activation of platelet hemostasis, a decrease in CPa-dependent fibrinolysis were noted in the patients with calculous pyelonephritis in the phase of active inflammation. These shifts were combined with disorders in the microcirculatory system: intermittent blood flow and disseminated erythrocyte aggregation, a prolonged period of nuclide half-life in the intracutaneous depot. In the patients with calculous pyelonephritis in the remission phase shifts in the system of hemostasis were less noticeable, microcirculatory disorders were undetectable.

[Changes in the indicators of the fibrinolytic and kallikrein-kinin systems in patients with calculous pyelonephritis]. / Izmeneniia pokazatelei fibrinoliticheskoi i kallikrein-kininovoi sistem u bol'nykh kal'kuleznym pielonefritom.

A total of 48 patients with calculous pyelonephritis were examined before and after surgery. A study was made of the fibrinolytic system (according to the status of XIIa kallikrein-dependent fibrinolysis, lysis of the plasma clots and euglobulin lysis) and of the kallikrein-kinin system of the plasma (according to kallikrein activity, kininogen content, kininase activity, spontaneous esterase activity and prekallikrein content). The patients with calculos pyelonephritis demonstrated KKS activation and fibrinolysis reduction related to both the lowering of the activator levels and elevation of antiplasmin levels, which in turn created the risk of thrombophilia in this group of patients.