ABSTRACT
Renal function in patients with stag-horn nephrolithiasis was assessed after two surgical treatments--percutaneous nephrolitholapaxy (PCN L) and pyelonephrolithotomy. The function of the operated and contralateral kidneys was studied early and late after operation by parameters of blood biochemistry, Doppler investigation of renal parenchyma, dynamic nephroscintigraphy. Stabilization or improvement of blood biochemical indices was observed in 58 (70%) patients. A secretory renal function late after surgery (from 6 months to 2 years) evidenced for improvement or stabilization of renal function (according to radionuclide test) in 71 (85.5%) patients. Integral parameters of renal blood flow were physiological or improved versus preoperative ones. PCNL was made in patients with deficient secretion less than 70%, 35 (87.5%) patients were diagnosed to have stabilization or functional improvement. After open intervention functional improvement took place in 11 (25.6%) patients, stabilization of renal function occurred in 25 (58.1%) patients. Tubular secretion deterioration was seen much more frequently in patients after open intervention. PCNL is less invasive surgical intervention than pyelonephrolithotomy as this technique produces milder surgical trauma and does not result in intraoperative renal ischemia. PCNL is the most effective surgical modality in stag-horn concrements of the kidneys and significantly expands potential of low-invasive treatment of such patients.
Subject(s)
Kidney Calculi/surgery , Kidney Function Tests , Kidney/physiopathology , Lithotripsy/methods , Nephrostomy, Percutaneous/methods , Female , Humans , Iodine Radioisotopes , Kidney/diagnostic imaging , Kidney/surgery , Kidney Calculi/blood , Kidney Calculi/diagnostic imaging , Kidney Calculi/physiopathology , Kidney Concentrating Ability , Male , Middle Aged , Radioisotope Renography , Treatment Outcome , UrodynamicsABSTRACT
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.
Subject(s)
Laser Therapy , Lipid Peroxidation/radiation effects , Peptides/analysis , Pyelonephritis/metabolism , Pyelonephritis/therapy , Urinary Calculi/metabolism , Urinary Calculi/therapy , beta 2-Microglobulin/analysis , Acute Disease , Combined Modality Therapy , Evaluation Studies as Topic , Hemoperfusion , Humans , Molecular Weight , Peptides/radiation effects , beta 2-Microglobulin/radiation effectsABSTRACT
Urological operations in children are made as a rule to correct congenital malformations. The prevention of operative injury to the child' body is secured only in conditions of adequate anesthesiological defense. This is possible only in availability of rapid information on cardiovascular, oxygen metabolic and hormonal statuses. Central hemodynamics, oxygen metabolism and hormonal findings have been summarized for 89 children. The above parameters were measured before and during plastic reconstruction of the upper urinary tract. Initially hyperkinetic hemodynamics because of inadequate premedication to control psychoemotional lability, changed for stable and hypokinetic circulation to the end of the operative intervention as a result of neuroleptanalgesia. Eukinetic trends were induced by balanced promedol analgesia throughout the operation. Concentrations of hydrocortisone, aldosterone and STH were on the increase, while T3 and T4 levels lowered. Hyperkinetic and eukinetic hemodynamics were observed postoperatively after neuroleptanalgesia and balanced promedol-including analgesia, respectively.
Subject(s)
Hemodynamics , Hormones/blood , Urinary Tract/abnormalities , Urinary Tract/surgery , Child , Humans , Intraoperative Period , Monitoring, Intraoperative/instrumentation , Neuroleptanalgesia , Postoperative PeriodABSTRACT
The authors studied changes of the beta 2-microglobulin level during hemodialysis with dialyzers AIP-02-02 (cuprophane membrane), E2 (cuprophane membrane), AIP-03-02 (polysulfone membrane), F60 (polysulfone membrane), and hemodiafiltration with dialyzer F60. The following data were obtained. The beta 2-microglobulin level in patients undergoing hemodialysis is approximately 20 times the normal level. No essential fluctuations of the level of this protein occurs during hemodialysis and hemodiafiltration. The cuprophane membrane does not cause increase of beta 2-microglobulin generation during hemodialysis. Standard hemodialysis with the cuprophane membrane and the highly-permeable polysulfone membrane does not lead to decrease of the beta 2-microglobulin level. Hemodiafiltration with the highly-permeable polysulfone membrane is an effective method for the elimination of this protein.
