Treatment of renal stones in Bulgaria in ancient times ('Hissarya' baths).

Well-known mineral baths in Bulgaria, 'Hissarya', are described. Their existence dates back more than 25 centuries. 'Hissarya' is an Arabic word meaning 'siege of a castle'. Remains of castle walls are the symbol of 'Hissarya' today. Every year more than 100,000 patients from Bulgaria and other countries visit 'Hissarya'. From the time of the Thracians and the Roman Empire until now renal stones have been successfully treated by drinking the mineral water and by taking baths. The Roman Emperor Septimius Severus (193-211) visited 'Hissarya' every spring to treat his renal disease.

Lipid peroxidation and vitamin E in red blood cells and plasma in hemodialysis patients under rhEPO treatment.

Lipid peroxidation, measured by malonyldialdehyde (MDA) and vitamin E in red blood cells (RBC) and plasma, was investigated in 25 hemodialysis (HD) patients before and after 6 months rhEPO therapy. RBC-MDA was significantly elevated, but plasma MDA was in the reference range. After recombinant human erythropoietin (rhEPO) treatment, the MDA level was significantly decreased in both compartments. Marked vitamin E deficiency was established in RBC as well as in plasma. rhEPO therapy restored vitamin E levels in both compartments. Our data suggest a possible positive rhEPO-antioxidant effect in HD patients.

[The effect of erythropoietin on megakaryocytopoiesis depressed by dialysable substances in experimental animals]. / Vliianie na eritropoetina vurkhu potisnata ot dializabilni veshtestva megakariotsitopoeza na opitni zhivotni.

The aim of the study is to examine influence of r-Hu-Ero on megakaryocytopoiesis in rats with depressed by dialysable substances thrombocytopoiesis. Experimental animals are male Wistar rats, treated with bidestilled water, used dialysis solution and r-Hu-Ero. We investigate bone marrow of experimental rats. More expressed increase of megakaryocyte count "pro mile" in rats with depressed megakaryocytopoiesis, as well as influence on megakaryocyte maturation for shorter period of time, provide evidence to be accepted that megakaryocytopoiesis, depressed by dialysable substances is more sensitive to stimulating effect of r-Hu-Ero. The reason for this enhanced sensitivity at present appear unclear.

Low prekallikrein and high angiotensin-converting enzyme activity in patients with chronic renal failure on haemodialysis.

Low prekallikrein is found in the plasma of patients with chronic renal failure (CRF) on intermittent haemodialysis (HD) (337 +/- 20.42 U/l before haemodialysis and 394.60 +/- 24.97 U/l after haemodialysis) versus normal data in the control group (755.80 +/- 24.37 U/l). Plasma activity of angiotensin converting enzyme (ACE) in patients with CRF is significantly decreased (14.91 +/- 0.57 U/l) in comparison to the control group (22.30 +/- 0.30 U/l). Intermittent haemodialysis increases plasma ACE activity. No differences exist after one haemodialysis procedure. There are no correlations between dialysis duration, plasma ACE activity, and prekallikrein. The ACE activity increase does not correlate with blood pressure but correlates significantly with the activation of complement and macrophage activity.

[External drainage of the thoracic duct with and without lymphosorption in the endotoxic phase of phalloid mushroom poisoning]. / Vunshen drenazh na grudniia protok sus i bez limfosorbtsiia v endotoksichnata faza na otravianiiata s faloidni gubi.

For the first time in Bulgaria and maybe in the world is reported very good therapeutic effect of the application of external drainage of the thoracic duct with and without lymphosorption in two consecutive cases of phalloid mushroom poisoning. Concrete indications are suggested for application of the method in this type of poisoning - in the late endotoxic phase of the poisoning when all other methods have been used with no effect.

Combined treatment of immune nephropathies with plasmapheresis and immunosuppressants.

The treatment of patients with immune nephropthies is discussed: rapidly progressive nephritis, lupus nephropathy, Wegener granulomatosis, Goodpasture syndrome, Schonlein-Henoch nephritis. A combined treatment of plasmapheresis and immunosuppressants is applied. A definite result, specially with the cases of Wegener granulomatosis, is registered for certain number of the patients. Together with the usual tests: CIC, immunoglobulins, complement, etc. a method for controlling of the detoxic efficiency of the treatment is suggested. This is a biologic method- the level of paramecium caudatum in media from patients' plasma is registered in relation to time. After plasmapheresis the life of paramecium caudatum is considerably prolonged.

[Determination of the effectiveness of plasma exchange in kidney diseases by a biological test]. / Opredeliane efektivnostta na plazmozamianata pri bubrechni zaboliavaniia chrez biologichen test.

Plasma toxicity and plasma exchange efficacy were studied in two groups of patients: I gr.--8 patients with various degree of disturbed renal function who did not need hemodialysis treatment; II gr.--9 patients treated by periodic hemodialysis. A biologic toxicity test was used together with the clinical, immunologic and biochemical indices as a criterion for plasma exchange efficacy. The test gives direct information for the total plasma toxicity which is of great advantage and helps in the decision for another plasma exchange.

[Treatment of Wegener's granulomatosis using plasmapheresis]. / Lechenie na granulomatozata na Vegener s plazmafereza.

A case with Wegener's granulomatosis in a young woman is described. The diagnosis was made after extirpation and histological investigation of granuloma tissue from the nasal concha and by needle renal biopsy. A successful treatment was carried out with plasmapheresis, hemodialysis and immune-suppressors, the acute paroxysm being coped as well as the developed acute renal insufficiency. After each plasmapheresis a considerable reduction of the circulating immune complexes was established. After a remission of 9 months the patient developed a stage of terminal chronic renal insufficiency and was subjected to chronic dialysis with good rehabilitation.

[Changes in the kallikrein-kinin system in chronic hemodialysis patients]. / Veränderungen im Kallikrein-Klinin-System bei chronischen Hämodialyse-Patienten.

The pre-kallikrein values, kallikrein inhibitors and protamine-splitting activity were determined in patients treated by means of chronic haemodialysis. Frequent use of dialysers leads to significant changes in the pre-kallikrein and kallikrein-inhibitor values. On the other hand the pre-kallikrein value remains unchanged after a single use of the capillary kidneys Hemoflow (Fresenius). A much smaller decrease in the kallikrein inhibitor value is observed than after frequent use of dialysers. In all the patients investigated the total protamine-splitting activity remained unchanged. Under these circumstances the inhibition capacity is probably sufficient to guarantee a control with respect to fibrinolysis, blood coagulation and the production of kinine.