[Clinical and immunological studies of the therapeutical effect of cytokines combined with 5-fluorouracil in metastatic kidney cancer]. / Kliniko-immunologicheskoe izuchenie lechebnogo vozdeistviia tsitokinov v sochetanii s 5-ftoruratsilom pri metastaziruiushchem rake pochki.

The authors present the results of a six-year clinicoimmunological study of a therapeutic effect of cytkins combined with 5-fluoruracyl in metastatic renal-cell carcinoma. Two therapeutic regiments have been used: rhIFN-a + 5-FU and rhIL-2 + RHifn-A + 5-FU. In cytokin-sensitive patients, both therapy protocols vrs conventional therapeutic alternatives (cytostatics, hormones, irradiation) have been shown to increase the frequency of achievement of remission by objective scoring and life span of the patients. There was an improvement in patients on having received the complex with IL-2 but a higher therapeutic effect appeared to be accompanied by substantial side effects. Recommendatory measures well-targeted to those patients with metastatic renal-cell carcinoma who are to be placed on cytokinotherapy are presented together with immunological indices to monitor the treatments administered and prognosis.

[Renal blood circulation in patients with vasorenal hypertension (based on ultrasonic dopplerography data)]. / Doslidzhennia nyrkovoho krovoobihu u khvorykh na vazorenal'nu hipertenziiu (za danymy ul'trazvukovoï doplerohrafiï).

In an evaluation of 25 patients, Vmax, Vmin, ratio in the stenosed renal artery (RA) was found to be significantly lower as compared with RA of control group patients, whereas the contralateral RA did not show any changes in the above parameter. Thus, under unilateral RA stenosis, there is an upward tendency in the difference between the values for stenosed RA and contralateral RA. Estimators of asymmetry appear to be significantly higher in main group patients, which fact suggest to us that results from doppler ultrasonography might provide an additional index to be taken into consideration in a setting where a patient is to undergo angiography.

[The radionuclide diagnosis of vasorenal hypertension using an angiotensin-converting enzyme inhibitor]. / Radionuklidnaia diagnostika vazorenal'noi gipertenzii s pomoshch'iu ingibitora angiotenzinprevrashchaiushchego fermenta.

Conventional routine renography and dynamic renoscintigraphy fail to yield sufficient diagnostic criteria in vasorenal hypertension, being associated with 21.5% false negative and 33.3% false positive results. Capoten induces statistically significant functional changes manifested by worsening of time-associated indicators of secretory-excretory function of the kidney, glomerular filtration rate and effective renal plasma flow on the side of the unilateral renal artery stenosis; relative hypotension in this situation leads to a statistically insignificant improvement of functional activity of the contralateral kidney parenchyma.

[Primary tumors of the kidney pelvis]. / Pervichnye opukholi lokhanki pochki.

Of 507 patients with renal tumours 36 (7.1%) presented with primary epithelial neoplasms of the renal pelvis. Histological investigation revealed benign papillomas in 3 (8.3%) cases. These patients underwent resection of the renal pelvis along with the tumour. Nephro-ureterectomy was performed in 33 patients, of whom 27 (75%) had it for transitional cell carcinoma, 5 (14%) for squamous cell carcinoma and 1 (2.7%) patient for solid carcinoma of the pelvis. Results of surgical treatment vary with the process stage so that the more advanced the stage, the poorer is the prognosis. High efficiency was shown of nephro-ureterectomy. At 5 years 9 of 13 operated on are alive without signs of metastatic disease.

[Use of loading renography in prognostication of results of the surgical treatment in renovascular hypertension]. / Ispol'zovanie nagruzochnoi renografii v prognozirovanii rezul'tatov khirurgicheskogo lecheniia vazorenal'noi gipertenzii.

In 22 and 19 patients with vasorenal hypertension the influence of exercise loading and capoten action on renal function accordingly were analyzed using the data obtained with the help of radionuclide renography. In 10 (45.4%) of 22 patients after the bicycle ergometry application the changes in hippuran transport occurred, in 12 (54.6%) the significant changes of renal function was not determined. In patients of these groups the arterial pressure after operation was accordingly 24.0/14.7 kPa (180/110 mm Hg) and 18.7/10.7 kPa (140/80 mm Hg). According to the data obtained with the help of radionuclide renography the curve height lowering was noted in 7 (36.9%) of 19 patients, and after capoten injection--in 18 (94.7%).

[The results of the organ-preserving surgical treatment of patients with kidney cancer]. / Rezul'taty organosokhraniaiushchego khirurgicheskogo lecheniia bol'nykh rakom pochki.

42 patients underwent conservative surgery for renal cancer. Conservative surgery was applied in 6 patients with only kidney, in 17--with unilateral cancer and contralateral kidney damaged by urological disease, in 17--with simultaneous tumorous process and in 8 patients with unilateral renal cancer and sound contralateral organ. Terms of postoperative follow-up ranged from 9 to 121 months, 14 patients have died for this period, exacerbation of cancer or metastasis being the cause of death in 9 of them. 5-year survival rate made up 64.4% although with regard to deaths related to cancer it equaled 81%. In 5 patients operated kidneys demonstrated complete functional failure due to nephrosclerosis. 5-year survival rate correlated inversely with advance of the process and was higher in unilateral lesions as compared to that of patients with bilateral tumors.

[Intravenous digital subtraction angiography in the diagnosis of urological diseases]. / Vnutrivennaia digital'naia cubtraktsionnaia angiografiia v diagnostike urologicheskikh zabolevanii.

The diagnostic possibilities of intravenous digital subtraction angiography (DSA) were evaluated in 2393 patients. The diagnostic value was 97.2%. DSA is contraindicated via the subclavian vein in children, inadequate preparation of the patients, vein abnormalities. The informative value was 92% in vasorenal hypertension, 100% in renal abnormalities, 85% in renal tumours. Intravenous DSA may be a screening method in the diagnosis of hypertension of unclear etiology, abnormalities of the upper urinary tract, while in tumours, especially of small size, DSA is a supplementary method to ultrasound and CT. The method is of economic importance.

[The results of the surgical treatment of patients with vasorenal hypertension complicated by chronic kidney failure]. / Rezul'taty khirurgicheskogo lecheniia bol'nykh vazorenal'noi gipertenziei, oslozhnennoi khronicheskoi pochechnoi nedostatochnost'iu.

Treatment results were studied in 45 patients with vasorenal hypertension complicated by chronic renal in failure after surgical treatment. Transarterial endarterectomy, roentgen endovascular dilatation of the renal arteries, splenorenal arterial anastomosis, renal autotransplantation were used. A hypotensive effect followed in 21 (46.7%), function improvement in 29 (64.4%). Causes of failures: nephrosclerosis due to prolonged hypertension, concomitant diseases of the upper urinary tract, technical complications of the operation.

[Roentgenoendovascular dilatation of the renal arteries in the treatment of vasorenal hypertension]. / Rentgenoéndovaskuliarnaia dilatatsiia pochechnykh arterii v lechenii vazorenal'noi gipertenzii.

The possibilities of the use of roentgenoendovascular dilatation of the renal artery were studied in 57 patients with stenosis of the renal artery and vasorenal hypertension. The authors managed to perform the manipulation in 48 patients. Occlusion of the renal artery, pronounced atherosclerosis of the iliac and axillary arteries, coarctation of the aorta were the causes of failure. In 52.6% of the patients, the "residue" of stenosis was less than 30% of the normal arterial lumen, in 31.6%--30-50%, in the remaining patients, the dilatation has failed. Stable normotension was achieved in 39.5%, the state improved in 50% of the patients. The absence of hypotensive effect for the first 6 mos after the operation was caused by recurrency of the dilated artery stenosis, which resulted from the improper choice of a balloon catheter. The diameter of such a catheter should be 100-110% of a width of the renal arterial lumen proximally to stenosis. The later recurrency of hypertension was caused by the development of the stenosis of the artery of the contralateral kidney.

[Morphologic changes of the kidneys in patients with vasorenal hypertension]. / Morfologicheskie izmeneniia pochek u bol'nykh s vazorenal'noi gipertenziei.

A study is presented of the state of blood vessels and parenchyma of the kidneys in patients with vasorenal hypertension. Morphological changes of the renal parenchyma at different stages of the disease are described. The authors compared clinico-morphological findings and give practical recommendations for the improvement of diagnosis of the disease and timing of surgical treatment of vasorenal hypertension.