[Fibronectin levels in blood, urine and kidney in children with kidney diseases]. / Soderzhanie fibronektina v krovi, moche i pochechnoi tkani pri bolezniakh pochek u detei.

The level of plasma fibronectin (FN) is increasing in prognostically unfavourable morphological forms of childrens glomerulonephritis being in direct relationship with the activity index and sclerosis index. Urine FN excretion depends upon generalization of the tubulointerstitial changes, presence in the kidney of synechia and segmentary sclerosis of the glomeruli capillaries. A direct correlation is established between FN in the renal tissue and the degree of the mesangial cell proliferation and the spread of sclerotic changes.

[Streptococcal infection and chronic glomerulonephritis in children]. / Streptokokkovaia infekstiia i khronicheskii glomerulonefrit u detei.

Microbiological, immunological and immunohistochemical studies were carried out in 78 children with different clinicomorphological forms of chronic glomerulonephritis (GN). According to the data obtained, the role of streptococcal infection (SI) is inconclusive in certain clinicomorphological forms of chronic GN, suggesting different approaches to the treatment of these patients. The etiological role of SI is most probable in mesangioproliferative and mesangiocapillary GN, manifesting by hematuric and mixed forms of chronic GN. Antibacterial therapy is indicated to patients with a rise of the level of ASL-O and with the clinical signs of acute SI or exacerbation of chronic tonsillitis in the same patients, especially during immunosuppressive therapy.

[Surgical tactics in multiple obstructions of the urinary tract in children]. / Khirurgicheskaia taktika pri mnozhestvennykh obstruktsiiakh mochevykh putei u detei.

One the basis of the results of surgical treatment of 84 children the authors identified 5 main groups of multiple obstructions: 1) obstruction of the vesicourethral segment in combination with obstructions of segments located above--37 (44.1%) patients; 2) unilateral obstruction of the ureterovesical and ureteropelvic segments--11 (13.1%) patients; 3) bilateral obstruction of the ureterovesical segments--19 (22.6%) patients; 4) bilateral obstruction of the ureteropelvic segments--11 (13.1%) patients; 5) other variants of obstructions of the ureterovesical and ureteropelvic segments--6 (7.1%) patients. It was established that urodynamic disorders conducive to the occurrence and progress of chronic pyelonephritis in multiple obstructions of the urinary tract in children are determined not only by the nature of congenital morphologic changes in the urodynamic segments, but by the features of their functions, interaction, and mutual influence, which should be taken into account in choosing the tactics of surgical intervention. In combination of obstruction in the vesicourethral segment, as well as in the ureterovesical segments, operative treatment should be started on the vesicourethral segment because urodynamics in the ureterovesical segments in children under 3 years of age may become normal without a surgical intervention on them. Correction of obstruction in the ureterovesical segment facilitates restoration of urodynamics in the ureteropelvic segment in unilateral obstructions, which determines the sequence of the operative intervention.

[Urinary microflora and the status of local immunity in children with cystitis]. / Mikroflora mochi i sostoianie mestnogo immuniteta u detei s tsistitom.

Study of the enzymatic and adhesive properties of E. coli isolated from the urine of children with cystitis has demonstrated that P-fimbriae, DNAase- and phosphatase-positive strains with pronounced hemolyzing and metabolic properties mostly occurred in children with associated cystitis and chronic obstructive pyelonephritis. In children suffering from cystitis, the changes on the part of local immunity manifested by the decrease of the content of SIgG in the urine and by the lack of SIgA1 and SIgA2. In children with a disease standing up to 3 years, the synthesis of IgA turned out dominant in the mucous membrane of the neck of the urinary bladder and in the trigone of the bladder, with IgG and IgM output being less intensive. The authors have proved the efficacy of the treatment with tomicide instilled into the urinary bladder of children suffering from cystitis.