[The concurrence of light-chain deposition disease, AL-amyloidosis, and cast nephropathy in a patient with multiple myeloma].

Despite of the fact that their clinical manifestations are similar, AL-amyloidosis (AL-A) and light chain deposition disease (LCDD) are individual nosological entities in view of considerable differences in their pathogenesis and pathomorphology. The paper describes a rare case of the concurrence of LCDD and AL-A in a patient with multiple myeloma. Clinically, there was dialysis-dependent renal failure, flail leg syndrome, myocardiopathy, and rhabdomyolysis. At the disease onset, his nephrobiopsy specimen could diagnose LCDD and myeloma or cast nephropathy. The disease was characterized by an aggressive course. Despite the administration of innovative agents, the patient had a short-term remission and died from disease progression. Autopsy additionally revealed amyloid deposition in the heart and kidney. The development of AL-A in the presence of prior LCDD may reflect the progression of the tumor and the appearance of an additional subclone of plasma cells that produce amyloidogenic light chains. The uncommonness of this case is that renal amyloid was found in the tubular casts and absent in the glomeruli, which may be considered as a special form--tubular AL-amyloidosis.

[Use of fractional plasma separation and adsorption (Prometheus technology) in the treatment of acute liver failure].

This paper presents the results of treating 8 patients with acute liver failure, by using the separation and adsorption of fractional plasma (Prometheus technology). Twenty-five procedures lasting 5-6 hours were performed. Anticoagulation with heparin was made under guidance of coagulogram parameters. The results of testing blood parameters before and after a procedure and hemodynamic parameters are given. The investigations have demonstrated the effectiveness and safety of the procedure.

[Use of continuous high-volume hemofiltration in patients with sepsis and multiple organ dysfunction].

The paper gives the authors' experience in performing continuous high-volume hemofiltration in 38 patients with sepsis and multiple organ failure. The kinetics of proinflammatory cytokines and a number of plasma enzymes as markers of substances having a relatively high molecular mass was studied. The advantages of a procedure using an artificial kidney apparatus equipped with an on-line substituting fluid preparation system are described. The possibilities of correcting the parameters of homeostasis are the principles of maintenance of a hemostatic system in this group of patients during the procedure are presented. The drawbacks of this technique are also described.

[Effectiveness of cycloferon in treating virus-associated inflammatory gynecologic diseases]. / Effektivnost' tsikloferona v lechenii virusassotsiirovannykh vospalitel'nykh ginekologicheskikh zabolevanii.

Cycloferon, a low molecular weight interferon inducer synthesized in Russia, was used for treating chronic acute gynecological inflammations. The etiology of diseases was mixed in the majority of cases. Clinical efficacy of the drug was 79%. Cycloferon, an antiviral immunomodulating drug, is recommended for combined therapy of chronic and acute gynecological inflammations.

[New approaches to the diagnosis and treatment of inflammatory diseases of the adnexa uteri]. / Novye podkhody v diagnostike i lechenii vospalitel'nykh zabolevanii pridatkov matki.

The paper summarizes follow-ups of 2500 patients with inflammatory diseases of the uterine appendages, provides evidence for the benefits of laparoscopic diagnosis and treatment of all types of this condition, which makes it possible to verify the diagnosis and perform less traumatic organ-sparing operations. To use combined antiinflammatory antibiotic therapy in view of the etiology of inflammation, as well as immunomodulators is the requisite condition for treating acute types of a disease. The new approaches to the diagnosis and treatment of inflammatory diseases of the uterine appendages substantially improved therapeutical outcomes and maintained female reproductive function.

[Comparative evaluation of the effectiveness of ofloxacin in comprehensive treatment of acute inflammatory diseases of the uterus and uterine appendages]. / Sravnitel'naia otsenka éffektivnosti ofloksatsina v kompleksnom lechenii ostrykh vospalitel'nykh zabolevanii matki i pridatkov.

Ofloxacin was used in the complex therapy of acute inflammatory diseases of the uterus and uterine appendages. The patients were divided into 2 groups. Group 1 included 15 patients treated with ofloxacin in a dose of 200 mg administered intravenously twice a day for 4 to 6 days. After that period the drug was used orally in the same dosage for 4 to 6 days. Group II was control and included 20 patients treated with some other broad spectrum antibiotics such as amplox, gentamicin and 3rd generation cephalosporins. Because of the disease severity in 33 patients they were subjected to surgical operations. The clinical recovery was stated in all the 35 patients. However, by a complex of the indices the efficacy of ofloxacin was higher than that of the other antibiotics. An improvement of the general state (no headache or weakness and normalization of the body temperature) was observed in the patients of group I 2-3 days earlier as compared to the patients of group II. Purulent discharge from the genitalia ceased 3-4 days earlier in the patients of group I by comparison with the control patients. Good tolerance of ofloxacin was observed and no severe adverse reactions were recorded.