[Local sorption therapy and its effectiveness in correction of endogenous intoxication in patients with acute purulent pyelonephritis and paranephritis].

The 118 operated patients with different forms of acute purulent pyelonephritis, including complicated with paranephritis were followed-up. Control group consisted of 65 similar patients who underwent traditional comprehensive treatment. Study group (n = 53) underwent additional wound dialysis with carbonic drainage-sorbent. Comparative analysis of the efficiency of the proposed method of drainage was carried out according to the clinical and laboratory parameters. The use of sorption therapy in patients with purulent and destructive forms of pyelonephritis and paranephritis allowed to reduce postoperative complications in patients of study group by 11%, as confirmed by the positive dynamics of the proinflammatory and anti-inflammatory cytokines. Moreover, the effectiveness of wound dialysis is justified by accelerated rehabilitation of patients and the possibility of discharge for 3 days before the control group of patients. The efficacy of wound dialysis (pyosorbtion) was equal to 18%.

[Chronic pyelonephritis in workers of chemical industry: pathogenesis and treatment].

The examination of 500 workers engaged in the production of chemicals detected chronic pyelonephritis in 81 (16%) of them. Such occupational hazards as furnace-charge dust, fly-powder, calcium petre in the air, intensify their toxic action on workers in high temperature and humidity (54-67%) at workplace and provoke pyelonephritis. An experimental model of pyelonephritis was developed in animals exposed to the above environmental hazards. Ceruloplasmin added to combined treatment of chronic pyelonephritis relieves endotoxicosis by reducing content of middle-mass molecules in blood plasma.

[Diagnosis and treatment of acute epididymoorchitis].

From 1963 we treated 330 patients aged from 15 to 85 years admitted to the urological clinic with acute epididymoorchitis of mild (n = 106), moderate (n = 82) and grave severity (n = 152). The diagnosis of purulent forms of epididymitis and epididymoorchitis was made basing on clinical and ultrasonic studies. Aspiration thin-needle puncture of epididymic membrane under ultrasonic control with calculation of leucocyte count was made for detection of purulent-process in 17 patients with epididymitis at the stage of diffuse inflammation. 198 patients with mild and moderate forms of acute epididymoorchitis received complex conservative treatment including laser therapy. 132 patients with severe epididymoorchitis were operated. In epididymoorchitis with total inflammatory-purulent process we made epididymectomy, in local - resection. The testis was removed in total necrosis or purulent lesion of its tissues. For comparison we analysed case histories of 150 patients with epididymoorchitis treated before 1983. Comparison of the treatment results in patients with acute inflammatory diseases of scrotal organs favours early surgical treatment.

[A variant of transvesical extraurethral adenomectomy].

To facilitate extraurethral adenomectomy, we used a semicylindric scalpel and metallic tube (tubus) to make a semioval cut parallel to proximal prostatic portion of the urethra along the posterior semicircle of the bladder neck in 260 patients with prostatic adenoma (PA). The urethra was isolated from the adenomatous tissues. The vesicular cut was prolonged left and right to the level of ureteral ostia. This manipulation was followed with bimanual index finger enucleation of adenomatous tissue. The defect of the vesicourethral segment was sutured with catgut or monocril. Extra-urethral adenomectomy with semicylindric scalpel injured prostatic urethra in lesser extent than endourethral adenomectomy, it reduced the risk of hemorrhage, entailed neither stricture of the posterior urethra nor incontinence of urine in the postoperative period.

[Bacteriostatic shock in acute purulent pyelonephritis]. / Bakteriotoksicheskii shok pri ostrom gnoinom pileonefrite.

Fifty-seven patients with acute purulent pyelonephritis (APP) complicated by bacteriotoxic shock (BTS) were treated in Daghestan Medical Academy's urological clinic from 1982 to 1999. The condition was primarily caused by acute occlusion of the urinary tracts. The first step of the treatment was aimed at the recovery of normal hemodynamics. As early as the first hours of BTS, plasma- and hemosorption, hemodialysis, hemodialysis were made. If the patients got better, they were operated to remove the obstruction for urine flow (epicystostomy, nephrostomy). 28 recent cases received adjuvant laser therapy--irradiation of the cavitary renal system and blood. This was performed via light guide inserted into the renal pelvis through the nephrostomic drainage. The guide was connected with the He-Ne optic quantum generator AFL-1. Laser procedure lasted for 8-12 min, a course consisted of 7-8 procedures. Later, laser beam was also directed to the biologically active points corresponding to pyelonephritis. Normalization of renal function and T, B immunity was faster in patients exposed to laser radiation. Lethality in this group was lower.

[The treatment of suppurative pyelonephritis]. / K voprosu lecheniia gnoinogo pielonefrita.

From 1986 in the urological clinic of the Dagestan Medical Academy 82 patients received surgical treatment for purulent pyelonephritis caused by urinary occlusion. Nephrostoma or pyelostoma were applied in most of the patients. In the postoperative period the patients were given antiinflammatory and infusion therapy. Recently, 40 patients were exposed to adjuvant laser treatment. The comparison of the treatment results demonstrated better outcomes in patients exposed to laser radiation. Normalization of renal function, T- and B-immunity in them was faster.

[Treatment problems in patients with prostatic adenoma]. / Nekotorye problemy lecheniia bol'nykh adenomoi predstatel'noi zhelezy.

The authors review treatment results for 947 patients with prostatic adenoma. The physicians used transvesical methods. Whatever its modification, transvesical adenomectomy performed endourethrally fails to bring good responses. The proportion of the complications remains great: urethral stricture 5.9%, cervical bladder stenosis 3.03%, enuresis 2.6%. In view of this, a method of transvesical adenomectomy performed extraurethrally is proposed. The technique implies application of special circular scalpel enabling the surgeon to dissect adenomatous nodules from prostatic urethra without its injury. The procedure produced good results in 32 patients with prostatic adenoma.

[The laser therapy of cystalgia]. / Lazeroterapiia tsistalgii.

The paper yields the results of treating patients with cystalgias. The conventional therapeutic techniques are low effective. The duration of out- and in-patient care is great, 24 days. Laser therapy was performed in 62 patients with cystalgias, including 30 who received a combined therapy due to concurrent diseases. An AFL-1 helium-neon optical maser generation radiation at a wave of 632.8 mM and at an output power of 18-20 mW has been employed in the treatment of cystalgias in the past 5 years. The biologically active points for urinary diseases were exposed to the laser therapy. With intercurrent diseases, the respective biologically active points or an inflammatory organ alone were additionally irradiated. No intra- and postoperative side effects were found. Laser therapy proved to be highly efficient in treating cystalgias, halving the average bed-days per patient.

[The treatment of pregnant women with pyelonephritis]. / Lechenie beremennykh, bol'nykh pielonefritom.

Results of combined therapy comprising laser treatment of acupuncture sites, venous blood and the renal pelvic mucosa approached through a nephrostomy drain and ureteral catheter have been analyzed in 80 pregnant women with pyelonephritis. Laser treatment supported by antibacterial, fluid, spasmolytic, antihypertensive and immunostimulator therapy proved to be an effective regimen.

[Choice of the treatment method in patients with acute inflammatory diseases of the scrotal organs]. / Vybor metoda lecheniia bol'nykh s ostrymi vospalitel'nymi zabolevaniiami organov moshonki.

The results of treatment for acute scrotal inflammations are reported. Conventional methods of conservative treatment are of little effect, while the duration of hospital stay is 24 days, and 25% of the patients are eventually readmitted to hospital for various complications. The choice of treatment strategy is made with reference to the clinical severity of acute epididymo-orchitis (mild, moderate and severe forms). Ninety-nine patients with mild and moderate acute epididymo-orchitis received combined conservative treatment. In the past two years, combined treatment has made use of a helium-neon optic quantum-mechanical oscillator, OKG-LG-12, producing beams with a wavelength of 632.8 nM and an output power of 18-20 mV. No side effects were identified during or after the laser treatment. Patients with severe conditions are subject to surgical treatment. Early surgical intervention includes the opening of testicular membranes, inspection of the epididymis and drainage. Postoperative patients were treated with broad-spectrum antibiotics and 3 or 4 sessions of laser therapy. The use of combined conservative treatment, incorporating laser therapy, for mild and moderate conditions, and surgical treatment for severe ones has shortened hospital stay two-fold, while the results have been good.

[Changes in blood composition and properties in children with external fistulae]. / Izmeneniia nekotorykh pokazatelei sostava i svoistv krovi u detei s naruzhnymi svishchami.

The investigation of the composition and properties of blood in 20 children with small intestine fistulas has revealed hypovolemia, disorders in the electrolyte composition, increased hematocrit and viscosity, changes of tests of coagulogram and thromboelastogram pointing to disseminated intravascular coagulation. Similar changes were noted in experimental studies in 20 dogs with duodenal fistulas. Drugs improving rheological properties of blood and anticoagulants gave better results of the treatment.

[Treatment of external intestinal fistulae]. / Lechenie naruzhnykh kishechnykh svischchei.

The authors observed 105 cases of external intestinal fistula of various localization and found that the destruction of the intestinal wall under the conditions of suppurative peritonitis, together with the tampons and drainage tubes inserted into the abdominal cavity and left there for a long period of time, constitute the main causes of the occurrnce of intestinal fistula. Surgical treatment of a lip-shaped fistula (63 cases) of the small intestine and colon, mainly by the intraabdominal method, was carried out. Tubular fistula was closed conservatively in 22 cases. The intestinal motor activity was studied in 20 cases and potassium iodide resorption was investigated in the experiments on 20 animals. Some practically important recommendations are given.