[Distribution and features of infection with hepatitis viruses B and C during hemodialysis treatment]. / Rasprostranennost' i osobennosti infitsirovaniia virusami gepatitov B i C v usloviiakh lecheniia gemodializom.

The prevalence of hepatitides B and C was evaluated in 140 patients treated by hemodialysis. Almost half of patients (48%) had acute hepatitis B which completely resolved. Acute hepatitis B was detected in 6% in the course of observation. In 6% chronic hepatitis B was diagnosed, and in 24% chronic hepatitis C. A combination of hepatitides B and C was diagnosed in 2% patients. Only 12% patients were not infected with hepatitis. Genotype 1b predominated in patients with HCV infection (73%); genotypes 1a, 21, and 3a were equally incident (9%). Replication of HBV and HCV in patients with uremia under conditions of hemodialysis was detected in 83 and 86% patients, respectively. Relationship between HBV and HCV infection and the duration of hemodialysis treatment was analyzed. The percentage of non-infected patients persistently decreased, and the time course of HBV and HCV infection was different. Infection with HBV after the beginning of hemodialysis occurred sooner (16.0 +/- 4.0 months) than with HCV (30.2 +/- 4.6 months, p < 0.04). The levels of SGPT and SGOT in patients with various manifestations of HBV and HCV infection treated by hemodialysis were followed up.

[Prediction of accelerated progression of chronic glomerulonephritis basing on clinical and histomorphological data]. / Prognozirovanie uskorennogo progressirovaniia khronicheskogo glomerulonefrita na osnovanii klinicheskikh i gistomorfologicheskikh dannykh.

AIM: To find out predictive value of three factors in progression of chronic glomerulonephritis (CGN): unfavorable clinical course, unfavorable morphological type and tubulointerstitial changes. MATERIALS AND METHODS: 150 CGN patients entered the trial. Frequency of onset of chronic renal failure (CRF) within 7 years after the diagnosis was chosen as a criterium of accelerated progression of CGN (AP CGN). Chi-square criterium was used for testing relationships between AP CGN and the parameters under study. RESULTS: The findings support previously published data on statistically more frequent occurrence of AP CGN in unfavorable clinical types (active nephritic and nephrotically-hypertensive), in unfavorable morphological types (mesangiocapillary CGN and focal-segmental hyalinosis/sclerosis and tubulointerstitial lesions). In unfavorable clinical types there was a significantly more frequent occurrence of AP CGN irrespective of unfavorable morphological changes. In contrast, both in unfavorable and favorable clinical types, frequency of AP CGN in unfavorable morphological types of CGN and tubulointerstitial changes was the same. CONCLUSION: Clinical type of CGN is a valuable prognostic criterium for AP CGN.

[Implication of clinical and morphological types of chronic glomerulonephritis, tubulointerstitial changes in prognosis of disease progression]. / Znachenie klinicheskogo i morfologicheskogo tipov khronicheskogo glomerulonefrita i tubulointerstitsial'nykh izmenenii dlia prognoza progressirovaniia zabolevaniia.

A highly significant relationship has been established between rapid progression of chronic glomerulonephritis and belonging to unfavorable category of clinical types according to classification of M. Ya. Ratner et al. (chi-square = 84.3, p < 0.001), to unfavorable category of morphological types (chi-square = 13.2, p < 0.01) and the presence of tubulointerstitial changes (chi-square = 32, p < 0.0001).

[The importance of a new classification of chronic glomerulonephritis for determining the prognosis of the disease]. / Znachenie novoi klassifikatsii khronicheskogo glomerulonefrita dlia opredeleniia prognoza zabolevaniia.

Dependence of chronic glomerulonephritis upon its clinical type was studied on the basis of observation in 165 patients of chronic renal failure incidence during 7 years after the beginning of the disease.

[Magnetic resonance tomography of the sellar region in patients with endocrine diseases]. / Magnitno-resonansnaia tomografiia selliarnoi oblasti u bolnykh s éndokrinnymi zabolevaniiami.

The authors discuss the present-day problems of radiotherapy. They show the major prospective trends in this field and describe the OS3Dplan system, made in this country, that represents a working place of a radiologist and serves for the development, analysis and storage of the schemes of long-distance gamma-beam therapy of oncologic patients. The OS3Dplan system is realized via the IBM PC/AT-286/287 computer but can operate with any of the IBM PC/XT/AT/PS-2--8086/80486 computers, made before 1986 with the videoadapter EGA/VGA, and functioning under MS-DOS, Microsoft (version 3.3 or older). The mathematical provision of the videodigitizer (distance control and videocamera) permit the introduction of videoinformation into the personal computer in the 256 x 256 format, 512 x 512 pixels. The mathematical provision of the OS3Dplan proper permits a volume planning of long-distance gamma-beam therapy. This module type system will be of interest for various specialists (radiologists, roentgenologists, oncologists, students, etc.), for it permits a collection and maintenance of a data bank on patients with imaging of roentgenograms, CT, NM tomography, ultrasonic data on the computer display and printing these data, perform metric analyses and reconstruct the volume.

[The prognosis of the accelerated progression of chronic glomerulonephritis]. / Prognozirovanie uskorennogo progressirovaniia khronicheskogo glomerulonefrita.

Based on the data of the 20-year follow-up of 146 patients suffering from intracapillary chronic glomerulonephritis (CGN) verified with the aid of nephrobiopsy, the conclusion was made about the necessity of distinguishing rapid-progressing CGN. In such pattern of CGN, chronic renal failure may occur for up to 5 years since the disease onset. A significant relationship was established between the incidence of rapid-progressing CGN and the morphological and clinical types as well as tubulointerstitial alterations. The clinical types included the active and inactive nephritic, nephrotic and nephrotic-hypertonic types. A regressive analysis made according to the Cox method permitted one to establish that the clinical type of CGN is the most reliable factor of predicting rapid-progressing disease.

[The tubulointerstitial component of chronic glomerulonephritis: its clinico-functional diagnosis]. / Tubulointerstitsial'nyi komponent khronicheskogo glomerulonefrita: kliniko-funktsional'naia diagnostika.

Tubulointerstitial alterations associated with chronic glomerulonephritis (CGN) are definitely dependent on the clinical type of CGN and are accompanied by a decrease of homeostatic functions (the rate of glomerular filtration, osmotic concentration and dilution of urine, hydruresis, the magnitude of CH2O, excretion of ammonium and hydrogen ions, the ratio of ammonium excretion to hydrogen ion excretion). Maximal osmotic concentration and ammonium excretion show an especially considerable decrease. The clinical type permitting one to diagnose rather than to reject the presence of alterations and the status of certain tubular functions, osmotic concentration in particular and, to a less degree, ammonium excretion, permitting to reject the presence of the tubulointerstitial component (TIC) are of known but restricted importance for TIC recognition. The TIC can be diagnosed more adequately in exploring definite pairs of renal functions, particularly osmotic concentration of urine and ammonium excretion and maximal hydruresis and excretion of hydrogen ions. This approach is both helpful in confirming and rejecting the presence of the TIC. Of special value is the combined assessment of the clinical type and maximal osmotic urine concentration data.

[Clinical and morphologic factors for assessment of risk of progression of chronic glomerulonephritis]. / Klinische und morphologische Faktoren zur Einschätzung der Progressionstendenz der chronischen Glomerulonephritis.

In 182 patients suffering from bioptical-proved and functional adapted chronic glomerulonephritis the relation between clinical course, morphological type and progression of disease has been evaluated. The presented results show a significant relation between the clinical course of chronic glomerulonephritis and the progression trend of this disease. The early finding of sclerotic changes may follow a benign course of the disease.

[Prognostic signs of accelerated progression of nephrotic types of chronic glomerulonephritis]. / Predvestniki uskorennogo progressirovaniia nefroticheskikh tipov khronicheskogo glomerulonefrita.

A prognostic value of some clinical and morphological signs was followed up in 43 patients with chronic glomerulonephritis concurrent with the nephrotic syndrome versus 85 with other clinical types of the disease. There was a statistically significant incidence of disease progression in combination with arterial hypertension, resistance of the nephrotic syndrome over 12 months and detection of sclerosing renal glomeruli and interstitium within 2 years after onset of the disease. The protracted course of the nephrotic syndrome is a precursor of occurrence of chronic renal failure. With less prolonged phases of the syndrome there is evidence for a long-term period of functional compensation. Occurrence of arterial hypertension early in the disease, as early renal parenchymal sclerosis, fails to predict the rates of chronic renal failure development. In the absence of these factors, the possibility of prompt disease progression may be rejected in all likelihood.

[The catamnestic assessment of the efficacy of combined pathogenetic therapy in patients with different clinico-morphological variants of chronic glomerulonephritis]. / Katamnesticheskaia otsenka éffektivnosti kompleksnoi patogeneticheskoi terapii bol'nykh s razlichnymi kliniko-morfologicheskimi variantami khronicheskogo glomerulonefrita.

In 70 patients with functionally compensated chronic glomerulonephritis (CGN), the disease outcomes were elucidated after the use of the 4-component therapy (a cytostatic, an anticoagulant, an antiaggregation agent and prednisone). The therapy appeared much more effective in the nephrotic types of CGN than in the active nephritic types. Remission was only attained in a subgroup of patients with the active types: with an early stage of the maximally active type of mesangiocapillary CGN. In the nephrotic type CGN, the therapy was effective in short-phase disease and ineffective in long persistence of that syndrome. In the nephrotic types, mesangioproliferative CGN as well as the short-phase nephrotic syndrome irrespective of the morphological type turned out predictors of a favourable outcome following the treatment. No effect can be predicted in focal segmental hyalinosis/sclerosis accompanied by arterial hypertension and the protracted nephrotic syndrome.

[Automated design of a diet for a patient with diabetes mellitus and obesity]. / Avtomatizirovannyi raschet diety bol'nomu sakharnym diabetom i ozhireniem.

A program of automated calculation of an individual diet for patients with diabetes mellitus and obesity has been worked out for the Elektronika HMC-80 PC. During a 15-20 min. interactive dialogue with the PC the caloric value and balance of a diet of 160 food items are assessed. Indices like sex, age, height, body mass, physical activity and diet are taken into account in dietary calculation. The testing of the program under clinical conditions has shown its multifunctional nature: it permits the detection of disturbed quantitative (caloric value) and qualitative (the ratio of proteins, fats and carbohydrates) indices of a diet, errors of an inpatient dietetic service and helps to form habits of nutritional culture in patients and medical staff.

Tubular function disturbances in chronic glomerulonephritis and their significance for identifying tubulointerstitial lesions.

The tubular and tubulointerstitial renal functions of 237 patients with chronic glomerulonephritis and functional compensation corresponding to their plasma creatinine levels were investigated and the results were compared with the light microscopic findings obtained by examination of kidney interstices obtained by biopsy. Pronounced structural interstitial lesions (TiC) were found in 30% of the cases. Investigation of the predictive values of tubular function data in respect of the presence or exclusion of TiC showed that, although individual parameters of the renal function permit the exclusion of TiC disturbances with a high degree of certainty, the diagnostic value can be enhanced by considering pairs of such parameters. Five parameter combinations were found to have the highest predictive value regarding the diagnosis of TiC. These were disturbed concentration capacity accompanied by reduced ammonia excretion or total acid excretion, reduced water diuresis accompanied by disturbed ammonia excretion or total acid elimination; and, finally, the total acid excretion and maximum dilution capacity. The highest predictive values for the exclusion of TiC are shown by inconspicuous concentration capacity accompanied by normal ammonia excretion, total acid excretion, water diuresis, free water clearance or urine dilution capacity.

[Correspondence of functional and structural findings in tubulo-interstitial disorders in chronic glomerulonephritis]. / Zur Ubereinstimmung funktioneller und struktureller Befunde der tubulo-interstitiellen Störung bei chronischer Glomerulonephritis.

In 237 patients with chronic glomerulonephritis and according to the serum creatinine level of functional compensation tubular and tubulointerstitial renal functions, respectively, were investigated and compared with the light-microscopic findings of the renal interstice. A distinct structural tubulointerstitial lesion (tiK) was found in 30%. The diagnostic predictivity for the recognition and the exclusion of the tiK was tested for single or paired data of the renal function. As a result it is possible with a suitable combination of parameters in on an average more than 80% of the cases to establish or to exclude function-diagnostically a tubulointerstitial structural lesion even in still inconspicuous creatinine values. From the clinical point of view thus the information value of functional diagnostic investigations of the renal water treatment is confirmed (concentration power, dilution ability, water diuresis), in which case the differentiated test of the renal acidification may supplement the informations about the tiK-situation.