Microvessel density is high in clear-cell renal cell carcinomas of Ukrainian patients exposed to chronic persistent low-dose ionizing radiation after the Chernobyl accident.

During the 25-year period subsequent to the Chernobyl accident, the morbidity of malignant renal tumors in Ukraine has increased from 4.7 to 10.7 per 100,000 of the total population. Recent studies of our group have shown that increases in morbidity, aggressiveness, and proliferative activity of renal cell carcinomas (RCCs), especially clear-cell renal cell carcinoma (CCRCC), in Ukrainian patients continuously inhabiting the radio-contaminated areas could be explained by specific molecular changes influenced by the so-called "chronic persistent low-dose ionizing radiation" (CPLDIR) exposure. This study aimed to examine the role of angiogenesis in CCRCC carcinogenesis associated with CPLDIR in patients living more than 20 years in cesium 137 ((137)Cs) contaminated areas after the Chernobyl accident in Ukraine. Paraffin-embedded specimens of 106 CCRCs were studied: Control cases were 18 tumors from Spanish patients (group 1), 25 tumors from Ukrainian patients from so-called clean areas without known radio-contamination (group 2), and 63 tumors from Ukrainian patients from radio-contaminated areas (group 3). For intratumoral microvessel density (MVD) determination, anti-CD31 antibody was used. A computerized image analysis program was used to quantitatively calculate the vascular density. Seventy-three percent of group 3 and 72 % of group 2 CCRCCs displayed the highest MVD. A striking increase in MVD was seen in group 3 CCRCCs, in comparison with groups 1 and 2 (p < 0.001). The majority of the hot spot vessels in group 3 was poorly differentiated. Moreover, MVD values for total vessels as well as for capillaries and tumor grade were strongly correlated. When we compared only tumor-node-metastasis tumor stages I and II, the differences remained statistically significant (p < 0.1). The ratio of the average total vessels and capillaries in the Ukrainian groups combined was 1.65:1 in comparison to the Spanish group. Our results provide evidence that CPLDIR exposure increases MVD (particularly capillary) in CCRCCs and is associated with a higher histological grade.

Methylation pattern of the putative tumor-suppressor gene LRRC3B promoter in clear cell renal cell carcinomas.

The leucine rich repeat containing 3B (LRRC3B) gene is a putative tumor suppressor located on human chromosome 3 in the 3p24 region. LRRC3B is frequently altered in colon and gastric cancers and also in leukaemias. In this study we investigated the promoter region methylation as a possible mechanism of LRRC3B gene inactivation in clear cell renal cell carcinomas. We found that the LRRC3B gene promoter was methylated in 43% of clear cell renal carcinoma samples. However, no correlation between DNA methylation and LRRC3B expression was found.

[Task-orientated therapy (target-therapy) directed to patients with renal cell carcinoma].

Two main ways playing a cardinal role in the pathogenesis of metastatic renal cell carcinoma (mRCC) have been identified in recent years, they are following: 1) a way of the mutation of a gene suppressor VHL (Van-Hippel-Lindau), stimulating various types of tyrosine-kinases participating in the development of tumors; 2) mTOR way, where ramapycyn plays a leading role, which effect proliferation and angiogenesis of mRCC. This discovery enabled the development of a new generation of highly effective medications for target-therapy of mRCCC--tyrosine-kinases inhibitors (VEGFR-1, VEGFR-2, VEGFR-3, PDGFR-alpha/PDGFR-beta, Raf-kinases, etc.) sunitimab, sorafenib, pazopanib, axitinib, etc. and mTOR inhibitors--everolimus and temsirolimus as well as monoclonal neutralising antibody VEGF (bevasizumab). The review is devoted to the analysis of antitumor activity, patient tolerance and side effect of these preparations in the system therapy of patients with mRCC.

[Clinical and immunological studies of the therapeutical effect of cytokines combined with 5-fluorouracil in metastatic kidney cancer]. / Kliniko-immunologicheskoe izuchenie lechebnogo vozdeistviia tsitokinov v sochetanii s 5-ftoruratsilom pri metastaziruiushchem rake pochki.

The authors present the results of a six-year clinicoimmunological study of a therapeutic effect of cytkins combined with 5-fluoruracyl in metastatic renal-cell carcinoma. Two therapeutic regiments have been used: rhIFN-a + 5-FU and rhIL-2 + RHifn-A + 5-FU. In cytokin-sensitive patients, both therapy protocols vrs conventional therapeutic alternatives (cytostatics, hormones, irradiation) have been shown to increase the frequency of achievement of remission by objective scoring and life span of the patients. There was an improvement in patients on having received the complex with IL-2 but a higher therapeutic effect appeared to be accompanied by substantial side effects. Recommendatory measures well-targeted to those patients with metastatic renal-cell carcinoma who are to be placed on cytokinotherapy are presented together with immunological indices to monitor the treatments administered and prognosis.

Studies on the application of dynamic surface tensiometry of serum and cerebrospinal liquid for diagnostics and monitoring of treatment in patients who have rheumatic, neurological or oncological diseases.

Human biological liquids comprise various surfactants, which adsorb at liquid interfaces and lead to a variation in surface tension. The adsorption processes involving low molecular weight surfactants, proteins and phospholipids play a vital role in the physiological functions of the human organism, especially if large surfaces are involved (e.g., gas exchange in lungs, metabolism of kidneys, liver and brain). Dynamic surface tensiometric studies of biological liquids like serum and cerebrospinal fluid provide surrogate parameters that reflect surface tension phenomena. We provide dynamic surface tension data of serum and cerebrospinal fluid that were collected from healthy volunteers and patients with rheumatic, neurological or oncological diseases. Our studies indicate that dynamic surface tension data are helpful for diagnostic purposes and for monitoring of therapeutic interventions.

[The clinico-immunological effects of leukinferon in the treatment of patients with acute suppurative pyelonephritis]. / Kliniko-immunologicheskie éffekty leikinferona pri lechenii bol'nykh s ostrym gnoinym pielonefritom.

A many as 20 patients with acute purulent pyelonephritis were studied for clinical and immunological effects of leukinferone. The above patients were convalescent earlier than control subjects. There were instances where clinical status was not accompanied by shifts in immunity. However, on an average in the group, such parameters as level of lymphocytes, amounts of B-cells, Igs G, A, T-helpers, and Tx/Tc ratio were found to be increased as was activity of EK-cells. Stimulating effects of leukinferone were particularly pronounced in those patients with decreased values for immunological status. A conclusion is reached to the effect that patients with acute pyelonephritis may benefit from those treatments involving the use of the above drug preparation.

[The clinico-immunological effects of T-activin in the combined treatment of patients with acute suppurative pyelonephritis]. / Kliniko-immunologicheskie éffekty T-aktivina v kompleksnom lechenii bol'nykh ostrym gnoinym pielonefritom.

Results were studied of use of T-activin in those clinical settings related to acute inflammatory diseases of the kidneys. There was a positive clinical effect from this preparation in all twenty-eight patients with acute purulent pyelonephritis, accompanied by readjustments in the patients' immune system. A rise to the norm was found to occur in T-helper counts, and accordingly, immunoregulatory index, NK-cell activity, blood microbocydic activity. The in vitro investigations done suggested the need for individual testing of immunocompetent cells of the patient to optimize the therapy.

[The treatment of prostatic adenoma by transurethral microwave therapy]. / Lechenie adenomy predstatel'noi zhelezy metodom transuretral'noi mikrovolnovoi terapii.

Patients with adenoma of the prostate appear to benefit from application of the unit "Prostatron" in one session without anesthesiologic maintenance and under outpatient conditions in the absolute majority of cases, as evidenced by reports from abroad and our own experience gained in the treatment of patients with adenoma of the prostate. This permits it to be recommended for widespread use in urological settings. Clinical, uroflowmetric and ultrasonic monitoring of the urogenital system status in patients with adenoma of the prostate, which is to be delivered in all such patients,--if used in combination with TUMWT,--becomes a means of really active assessment of treatment effectiveness rather than a passive recording of the moment of worsening of the patient' state.

[The radionuclide diagnosis of vasorenal hypertension using an angiotensin-converting enzyme inhibitor]. / Radionuklidnaia diagnostika vazorenal'noi gipertenzii s pomoshch'iu ingibitora angiotenzinprevrashchaiushchego fermenta.

Conventional routine renography and dynamic renoscintigraphy fail to yield sufficient diagnostic criteria in vasorenal hypertension, being associated with 21.5% false negative and 33.3% false positive results. Capoten induces statistically significant functional changes manifested by worsening of time-associated indicators of secretory-excretory function of the kidney, glomerular filtration rate and effective renal plasma flow on the side of the unilateral renal artery stenosis; relative hypotension in this situation leads to a statistically insignificant improvement of functional activity of the contralateral kidney parenchyma.

[Neuroelectromyographic study methods in the complex diagnosis of urinary incontinence in women]. / Neiroélektromiograficheskie metody issledovaniia v kompleksnoi diagnostike nederzhaniia mochi u zhenshchin.

With the purpose of improving a differential diagnosis between stress and urgent forms of UI (urinary incontinence), functional condition was studied of lower urinary tract in 62 women suffering from the above pathologies, using general clinical, urologic and neuroelectromyographic methods. In women suffering from urinary incontinence, a decrease is noted of contractile activity of all the anatomical formations responsible for the continence of urine, and the pattern of the electromyograms recorded permits identification of the form of the pathology. The authors hold the view that the onset of an UI symptom in the majority of the examinees is associated with the degenerative dystrophic lesion of the lumbosacral portion of the spine.

[Primary tumors of the kidney pelvis]. / Pervichnye opukholi lokhanki pochki.

Of 507 patients with renal tumours 36 (7.1%) presented with primary epithelial neoplasms of the renal pelvis. Histological investigation revealed benign papillomas in 3 (8.3%) cases. These patients underwent resection of the renal pelvis along with the tumour. Nephro-ureterectomy was performed in 33 patients, of whom 27 (75%) had it for transitional cell carcinoma, 5 (14%) for squamous cell carcinoma and 1 (2.7%) patient for solid carcinoma of the pelvis. Results of surgical treatment vary with the process stage so that the more advanced the stage, the poorer is the prognosis. High efficiency was shown of nephro-ureterectomy. At 5 years 9 of 13 operated on are alive without signs of metastatic disease.

[Use of loading renography in prognostication of results of the surgical treatment in renovascular hypertension]. / Ispol'zovanie nagruzochnoi renografii v prognozirovanii rezul'tatov khirurgicheskogo lecheniia vazorenal'noi gipertenzii.

In 22 and 19 patients with vasorenal hypertension the influence of exercise loading and capoten action on renal function accordingly were analyzed using the data obtained with the help of radionuclide renography. In 10 (45.4%) of 22 patients after the bicycle ergometry application the changes in hippuran transport occurred, in 12 (54.6%) the significant changes of renal function was not determined. In patients of these groups the arterial pressure after operation was accordingly 24.0/14.7 kPa (180/110 mm Hg) and 18.7/10.7 kPa (140/80 mm Hg). According to the data obtained with the help of radionuclide renography the curve height lowering was noted in 7 (36.9%) of 19 patients, and after capoten injection--in 18 (94.7%).

[The ultrasonic diagnosis of renal tuberculosis]. / Ul'trazvukovaia diagnostika tuberkuleza pochek.

Informative value of ultrasonography potential in the diagnosis of nephrotuberculosis was studied by comparison with conventional x-ray and intraoperative findings in 78 relevant patients. Three patterns of renal ultrasonic architectonics changes in nephrotuberculosis were revealed: 1) focal heterogeneity of renal parenchyma, 2) pseudocystic type, 3) hydronephrotic transformation. It is concluded that ultrasonography is superior to routine diagnostic methods, but is recommended for use in combination with standard methods of phthisiourological diagnosis.

[The results of the organ-preserving surgical treatment of patients with kidney cancer]. / Rezul'taty organosokhraniaiushchego khirurgicheskogo lecheniia bol'nykh rakom pochki.

42 patients underwent conservative surgery for renal cancer. Conservative surgery was applied in 6 patients with only kidney, in 17--with unilateral cancer and contralateral kidney damaged by urological disease, in 17--with simultaneous tumorous process and in 8 patients with unilateral renal cancer and sound contralateral organ. Terms of postoperative follow-up ranged from 9 to 121 months, 14 patients have died for this period, exacerbation of cancer or metastasis being the cause of death in 9 of them. 5-year survival rate made up 64.4% although with regard to deaths related to cancer it equaled 81%. In 5 patients operated kidneys demonstrated complete functional failure due to nephrosclerosis. 5-year survival rate correlated inversely with advance of the process and was higher in unilateral lesions as compared to that of patients with bilateral tumors.

[The effect of different types of recombinant interferon on the induction of 2,5-oligoadenylate synthetase in natural killers and the tumor cells in bladder cancer patients]. / Vliianie razlichnykh tipov rekombinantnogo interferona na induktsiiu 2,5-oligoadenilatsintetazy v estestvennykh killerakh i kletkakh opukholi u bol'nykh rakom mochevogo puzyria.

Recombinant interferon treatment of donors' and bladder cancer patients' lymphocytes results in activation of natural killer cells which is in correlation with enhanced activity of 2,5-oligoadenylate synthetase in them. The study of sensitivity of bladder cancer cell primary cultures showed that the cells are sensitive to various interferons virtually in all the cases observed as indicated by high synthetase activity. The baseline level of 2,5-oligoadenylate synthetase in tumor cells surpassed that in natural killers from healthy donors which may be related to elevated levels of serum gamma-interferon in the above patients.

[The role of echo scanning of the kidneys in the diagnosis of acute pyelonephritis]. / Rol' ékhoskanirovaniia pochek v diagnostike ostrogo pielonefrita.

The role of echo scanning in the diagnosis of acute pyelonephritis was evaluated in 123 patients. It was established that ultrasonography in acute pyelonephritis is a highly informative diagnostic method. The importance is high in acute obstructive pyelonephritis and less informative in acute non-obstructive pyelonephritis. The method has no equal counterparts in the most difficult cases for diagnosis. Association of renal echo scanning with traditional method significantly increases the diagnosis quality.

[Enterosorption in the treatment of chronic kidney failure in patients with surgical diseases of the kidneys]. / Enterosorbtsiia v lechenii khronicheskoi pochechnoi nedostatochnosti u bol'nykh s khirurgicheskimi zabolevaniiami pochek.

Enterosgel was used in 89 patients with different stages of renal failure treated surgically and medically. It is concluded that isolated or complex detoxication using enterosgel is a perspective approach in the treatment of patients with surgical renal diseases complicated by chronic renal failure. The use of enterosorption in the preoperative period allows to perform operative intervention in situations when infusion treatment by traditional methods was not sufficient.