[The Dynamics of Primary Disability and Establishment of Losses of Healthy Life-Span of Able-Bodied Population of the Ryazan Oblast].

The problem of disability being a cause of decreasing of healthy life-span is actual especially nowadays when during last decade rate of increasing of primary disability of able-bodied population significantly advances mortality harming economics. The article considers dynamics of primary disability of population of the Ryazan oblast. The analysis of losses of healthy life-span of able-bodied population of the region caused by disability is implemented.

[The diagnosis of vesicopelvic reflux in pregnant women]. / Diagnostika puzyrno-lokhanochnogo refliuksa u beremennykh.

The diagnosis of vesicopelvic reflux (VPR) in pregnancy is not a simple task because of the requirements of noninvasiveness, safety, minimum radiation load, informative value. The authors suggest urinalysis and ultrasound (US) investigation as VPR screening tests in pregnancy. US VPR diagnosis meets the requirements of a screening method, has the advantages of a high VPR detection capacity, noninvasiveness, feasibility of further US monitoring, simultaneous study of the urological and obstetric status. High frequency of pre- and postnatal urinary reflux, the gape of the ureteral ostia as indirect signals of VPR in pregnant patients suggest that VPR may be characteristic of pregnancy, specific "pregnancy phenomenon". The authors provide US VPR classification the stages of which are usable in VPR and its complications prophylaxis.

[The diagnosis of vasorenal arterial hypertension]. / Diagnostika vazorenal'noi arterial'noi gipertenzii.

Clinical and specific examination of 525 patients with special emphasis on ultrasonic, radionuclide and angiographic procedures, a captopril pharmaco-radiological test, radioimmunoassay of renin in the renal vein and vena cava inferior provided the diagnosis of vasorenal hypertension (VRH) in 65 of them (30 males, 35 females at the age of 18-60). Among etiological factors atherosclerosis, fibromuscular dysplasia, nephroptosis, renal artery aneurysm, aortic arteritis were involved in 40%, 24.6%, 16.9%, 12.3%, 6.2% of the cases, respectively. Chronic renal failure developed in 17% of VRH patients with the disease duration more than 3 years. Also, aspects of evaluation of cardiovascular function with invasive and noninvasive techniques in pre-, intra- and postoperative periods, indications to VRH, basic operative procedures are reviewed. According to WHO criteria, a complete response was obtained in 21 (35.6%), a partial response in 34 (57.6%) patients, no response was registered in 1 (1.7%) case.

[Stabilization of a conducting channel in lipid bilayer membranes by an electric field]. / Stabilizatsiia provodiashchego kanala v bisloinykh lipidnykh membranakh élektricheskim polem.

A strong transversal electric field is shown to stabilize a macroscopic conducting pore in a lipid membrane. The dependence of the pore radius on the applied voltage is obtained.

[Kidney functions after electropiezolithotripsy]. / Funktsii pochek posle élektropiezolitotripsii.

To study the effect of the "Piezolit-2300" impulses on renal parenchyma at electropiezolithotripsy (EPL), the authors employed dynamic nephroscintigraphy (10 patients) and indirect angiography (10 patients) with 131I-hippuran and 99mTc-Mag3. The measurements were made before EPL and during 24 hours after it. No serious changes in either the target or contralateral kidney were observed because of a high-pressure small zone in the generator focus. Minor traumatism of the method allows its outpatient application as well as repeat use in case of large concrements.

[The effect of upper urinary tract interior drainage on urodynamics and contractile function of the ureteral wall]. / Vliianie vnutrennego drenirovaniia verkhnikh mochevykh putei na urodinamiku i sokratitel'nuiu funktsiiu stenki mochetochnika.

S-stents were introduced to the upper urinary tracts of experimental dogs on a period from 1 week to 11 months. It was found mild ureter dilation, the increased ureter pressure, refluxes along the upper urinary tract, the lowered flow resistance during perfusion and diuretic loads. Isolated ureter wall fragments demonstrated the diminished contractility in vitro, and the mode of their contractile force adrenergic regulation was modified. The reduced ureter pressure during large flows after indwelling S-stents to the ureters may be the factor that facilitated the renal and ureter stones removing but the decreased contractility and ureter refluxes emphasized that the period of stent implantation to the upper urinary tracts must be pathogenetically and clinically evident.

[A method for modelling obstructive and nonobstructive hydroureteronephrosis (experimental research)]. / Metod modelirovaniia obstruktivnogo i neobstruktivnogo gidroureteronefroza (éksperimental'noe issledovanie).

An experimental model of the upper urinary tract obstruction by means of cryosurgical liquid nitrogen destruction of an ureteral part has been created. The rabbit models provided obstructive ureterohydronephrosis in 100% of the animals, 56% of the dogs developed ureteral stricture in line with urodynamic alterations, the rest 44% had symptoms of nonobstructive ureterohydronephrosis as shown by excretory urography and dynamic nephroscintigraphy. One--three months after the destruction in dogs there were shifts in the intra-ureteral pressure and bioelectric activity, contractility of the fragments. The histological examination of the sections revealed necrosis at the destroyed site in the early postexposure period (2 weeks) followed by sclerosis and circulatory disturbances later on (3 months). The technique is simple, feasible in all laboratory animal species, highly reproducible.

[Experimental megaureter in dogs: modeling by "devitalization" of a segment of the ureter and features of the course]. / Eksperimental'nyi megaureter u sobak: modelirovanie putem "devitalizatsii" uchastka mochetochnika i osobennosti techeniia.

The method of experimental megaureter modelling in dogs that is based on the operative damage of the ureter segment is described. Obstructive megaureter was found in 100% of "devitalization" of the ureterovesical junction and in 59% of "devitalization" of the middle third of ureter. Progression of megaureter symptoms and reduction of evacuator-secretory function on the side of modelling operation without anatomical narrowing of the ureter lumen in 41% of experiments pointed to the actual role of the functional obstruction in pathogenesis of this hard syndrome. In vitro methods demonstrated the decrease of contractility of the "devitalized" fragments and also of above and below situated segments of megaureter. Urodynamic investigations showed the signs of the bioelectrical disturbance in the megaureter wall and the disorder in excitement and contraction of the megaureter, deterioration of the reactivity of the megaureter on the functional loading tests.

[The diagnosis and treatment of cystic diseases of the kidneys by using transcutaneous puncture methods under ultrasonic monitoring]. / Diagnostika i lechenie kistoznykh zabolevanii pochek s pomoshch'iu chreskozhnykh punktsionnykh metodov pod ul'trazvukovym kontrolem.

Presented in the paper are the methods of ultrasonic diagnosis and percutaneous paracentetic treatment of cystic kidneys under ultrasonic monitoring. Paracenteses were performed in 172 patients: 59 with polycystic and 113 with cystic kidneys. If the cysts located in the middle or lower segments of posterior, lateral or inferior drainage that was pushed through the guide into the cyst lumen. A thin-needle aspiration was used and the drainage avoided if the cyst located in the anterior part of middle or upper renal segments. Cystography and cystomanometry associated with the determination of the cyst tension index followed elimination of the aspirates for cyto- and bacteriological investigations. Paracentesis was accomplished under the ultrasonic monitoring of the position of a needle tip. The cavity of the cyst was sclerosed with 96% spirit in 84 patients; strong radiopaque agents were used in 8 and medicinal cyanacrylate glue in 13 patients. The drainage of the cysts with a long-term exposure to sclerosing agents (from 2 to 24 hrs) was employed in 32 patients. Postaspiration relapses were documented in all the patients with intrasinus cysts and cysts, whose major portion was surrounded by parenchyma. In the patients with other patterns of cyst location, the postaspiration relapses were noted in 94.4 per cent. A four-year follow-up of 13 patients who sustained the glue application registered 2 relapses which were successfully cured by a repeat application of the glue.(ABSTRACT TRUNCATED AT 250 WORDS)

[Are the sequelae predictable for sectional and multiple partial nephrolithotomies of completely intrarenal coral stones? (experimental and clinical research)]. / Predskazuemy li posledstviia sektsionnoi i mnozhestvennykh partsial'nykh nefrolitotomii po povodu polnost'iu vnutripochechnykh korallovidnykh kamnei? (éksperimental'no-klinicheskoe issledovanie).

In the assessment of surgical intervention for fully intrarenal stone casts, different kinds of nephrotomies (sectional or multiple partial ones, those supplementing pyelolithotomy or performed in the kidneys with marked parenchyma) should be compared in terms of functional outcomes, severity and incidence of complications (intraoperative or postoperative bleeding from the violated kidney), postoperative urinary fistulas, aggravated renal failure and postoperative mortality. It is these milestones that have determined the scope of the present study. An experimental assessment of the degree of trauma, associated with sectional nephrolithotomy as well as its functional sequelae was made in dogs after a stone-like structure was simulated and the kidney reached the necessary degree of secretory deficiency. The comparison of pre- and postoperative renographic parameters over different spans of follow-up of animals after sectional nephrolithotomy was made to assess the latter's organ-damaging effect and, in part, functional results of surgery in a kidney with a profound functional deficiency by the time of the operation. A similar methodology was used in clinical patients, subjected to nephrolithotomy (either sectional or multiple partial procedure) for fully intrarenal coral stones. Functional results of nephrolithotomies in animals and in patients are presented in Figs 1-3. For cases where postoperative results were good or satisfactory at 1-2 months, follow-up results are presented in Tables 4-5. Postoperative complications of sectional and partial nephrolithotomies are reflected in Figs. 4-5. The incidence of paranephritis and postoperative mortality are reported in Tables 6-7. Therefore, functional results of sectional nephrolithotomy are indicative of its considerable organ-sparing effect in experimental animals. Functional outcomes of the clinical sectional and multiple partial nephrolithotomies are similar, yet partial nephrolithotomies are more detrimental to the kidney and the upper urinary tract in terms of the pattern and rate of postoperative complications, as compared to sectional nephrolithotomy. As the sequelae of sectional and partial nephrolithotomies are largely unpredictable, indications for surgical removal of intrarenal stereometrically-composite coral stones should be as limited as possible.

[Effect of intensive physical loads on renal function]. / Vozdeistvie intensivnykh fizicheskikh nagruzok na funktsional'noe sostoianie pochek.

The purpose of the study was to evaluate the extent of renal functional disorders, developing in response to muscular exercise of varying intensity and duration in 64 professional athletes, aged 17 to 26 years. Comparative characteristics of 131I-hippuran kinetics through the urinary tract both at rest and after "acute" (single) and chronic (many years') physical exercise are obtained. There was a direct relationship between effective renal blood flow and the magnitude of muscular exercise. It is demonstrated that post-exercise renal changes disappear without trace, while individuals, exposed to extreme muscular stress for long periods of time, i.e. the professional athletes, may develop irreversible functional changes. Impaired renal function can hardly be attributed to the emergence of yet another compensatory mechanism, for such notions as 'compensation' and "persistent impairement of functional potentials of an organ" are mutually exclusive.