[The Whitaker perfusion test in the diagnosis of organic obstruction of the upper urinary tract]. / Perfuzionnyi test Whitaker v diagnostike organicheskoi obstruktsii verkhnikh mochevykh putei.

The X-ray and radioisotopic tools currently used in the diagnosis of upper urinary obstruction fail to take into account the dynamics of the ureter and largely depend on preserved renal function. Therefore Whitaker's test was proposed for this, which involves fluid perfusion along the nephrostomic drain and measurement of intrapelvic pressure. The test was employed in 40 patients and confirmed antegrade pyeloureterographic evidence in 32 (80%) patients, but failed in 8 (20%) patients who were suspected for upper urinary obstruction as shown by anterograde pyeloureterographic findings, whereas the perfusion test excluded the obstruction. The test provided evidence for the obstruction in 6 out of 26 cases, though antegrade pyeloureterography indicated as if the patency of the upper urinary tract were good. The results of Whitaker's test were supported by further clinical examinations and treatment of the patients. Two clinical cases are presented in the paper. It is concluded that Whitaker's perfusion test yields more accurate and objective data on the presence of organic obstruction of the upper urinary tract than do radioisotopic and X-ray tools. So the authors consider it advisable to apply it especially when it is questioned whether the obstruction is present or absent, as well as in patients undergone upper urinary plastic operations.

[Percutaneous endopyelotomy]. / Perkutannaia éndopielotomiia.

The paper deals with an endoscopic correction technique for ureteropelvic stricture, namely percutaneous endopyelotomy. The authors employed the technique in 16 patients both with primary and postoperative strictures of a ureteropelvic segment. Endopyelotomy was concomitant with nephrolith extraction in some cases. The diagnosis and outcomes of the therapy were assessed from X-ray, radioisotopic, and urodynamic findings. The specific features of percutaneous endopyelotomic techniques: paracentetic nephrostomy through the upper and middle calices, introduction of a guidewire along the ureter and an auxiliary wire into the pelvis, bougienage of the nephrostomic fistula and introduction of a nephroscope into the pelvis, dissection of the stricture using a cold knife, and splintage of the ureteropelvic stricture are also described. The authors note good results of the therapy and consider the technique to be highly effective. The technique is found to be superior to open pyeloplasty.

[Plasmapheresis in the complex treatment of nonspecific ulcerative colitis]. / Plazmotsitaferez v kompleksnoi terapii nespetsificheskogo iazvennogo kolita.

An experience with using the apparatus plasmacytapheresis in 16 patients with nonspecific ulcer colitis has revealed its high effectiveness mainly in patients with mild and middle-severity forms of the disease. Convincing data were obtained on the improvement of clinical, biochemical and immunological processes. The method can be used in ambulatory conditions for supporting therapy of the patients.

[Drainage of the thoracic duct in the complex treatment of progressive forms of multiple sclerosis]. / Drenirovanie grudnogo limfaticheskogo protoka v kompleksnoi terapii progredientnykh form rasseiannogo skleroza.

The results of clinical and modern immunological studies (assessment of T- and B-lymphocytes in the blood, cerebrospinal fluid and lymph) promoted the authors to operate (drainage of the thoracic lymphatic duct) on six patients with disseminated sclerosis to try to control their pathologically altered immune homeostasis. A rationale for a new type of pathogenetic therapy of progressive disseminated sclerosis which is tolerant to many therapeutic methods employed previously including immunodepression and immunostimulation is presented.