[The role of dynamic observation in the prevention of recurrences of stone formation]. / Rol' dinamicheskogo nabliudeniia v profilaktike retsidivov kamneobrazovaniia.

26 patients with recurrent and non-recurrent urolithiasis treated surgically or by lithotripsy and 14 patients free of urolithiasis were examined biochemically by 9 metabolic blood and urine parameters and using Litos test proposed by urologists of the Moscow Regional Research Clinical Institute for detecting lithogenesis in the kidneys. The comparison of the findings obtained with biochemical and Litos tests showed that these tests are mutually complementary. Monitoring of urolithiasis patients should be complex, i.e. including biochemical examination for disbolism and urinalysis by means of Litos test.

[Lipid peroxidation in the kidney tissue of patients with nephrolithiasis and chronic pyelonephritis]. / Perekisnoe okislenie lipidov v pochechnoi tkani bol'nykh nefrolitiazom i khronicheskim pielonefritom.

Lipid peroxidation (LPO) activity has been analyzed in homogenates and microsomes of cortical samples obtained intraoperatively from the kidneys of 33 patients. Of them, 21 patients had mild, moderate or severe pyelonephritis or nephrolithiasis. Unaffected cortical tissue from renal carcinoma patients was used as control. LPO activity was judged by basal level of malonic dialdehyde (MDA) and MDA growth in the homogenate and microsomes following initiation of ascorbate-dependent LPO. Activation of LPO was registered in patients with moderate disease with active inflammation. They also exhibited greater MDA basal levels and rapid MDA increase in response to in vitro initiation of ascorbate-dependent LPO simultaneously with attenuation of endogenous antioxidant defense. In severe pyelonephritis and nephrolithiasis with drastic deficiency of renal function LPO activity was low and nonresponsive to stimulation either by ascorbate or Fe+2. This is probably due to lack of the substrate after massive death of renal cells. Enhancement of LPO activity in patients with pyelonephritis or nephrolithiasis against functioning kidneys may appear responsible for destruction of renal tissue.

[Lomefloxacin in the treatment and prevention of urogenital infection]. / Lomefloksatsin pri lechenii i profilaktike infektsii mochepolovykh organov.

A new antibiotic from fluoroquinolone series maxaquine (lomefloxacin) made in USA (Searle [correction of Surl]) has been tried in the treatment of urogenital infection (chronic cystitis, prostatitis, pyelonephritis, acute epididymitis, chlamydial urethroprostatitis) as well as to warrant antibacterial preparation before extracorporeal lithotripsy. The duration of the treatment course (3-28 days) was oriented to nosological form. The 24-h dose ranged from 400 to 800 mg. Side effects manifested with dyspepsia in 4 patients, worsening of memory in 2 patients. Photosensitization did not occur. Maxaquine clinical efficacy is similar to aminoglycosides and is superior to cephalosporins of the third generation. As for fluoroquinolone antibiotics, maxaquine can be compared to cyprofloxacine. The drug proved effective against urethroprostatitis and urethrocystitis of chlamydial origin. The responses to maxaquine favour its application in hospitals as second-line drug, whereas outpatiently it can be used for short-term empiric therapy.

Liposoluble vitamins E and A in human renal cortex and renal cell carcinomas.

Vitamin E was quantified in renal cell carcinomas (RCC) and in 'intact' renal cortex, obtained from 31 patients subjected either to unilateral nephrectomy or to partial resection of the only kidney. Histologically, 14 tumors consisted predominantly of clear cells (group 1) and 17 of other cell types (group 2). In both groups, a significant increase in vitamin E concentration, as compared to the 'intact' cortex, was observed: 167.8 +/- 27.9 and 68.2 +/- 15.2 micrograms/g wet tissue weight (mean +/- SEM) for groups 1 and 2, respectively, versus 10.1 +/- 0.53 micrograms/g wet tissue weight for the cortex. Although the total lipid content was also increased in tumors (especially in group 1), the vitamin E concentration in tumor tissue, calculated per milligram of total lipids, proved to be much higher in both groups than in 'intact' cortex. A significant positive correlation was observed between vitamin E and total lipid content in group 1 and 2 carcinomas. It was also found that vitamin E accumulation in RCC is unlikely to be attributed to an enhanced lipid deposit in the tumor cells. Thus, in 8 tumors of group 2 the vitamin E levels were markedly enhanced although these tumors did not differ from the cortex in total lipid concentrations. Vitamin A content determined in 17 carcinomas, when calculated per milligram of total lipids, was the same as in 'intact' cortex.

[The correction of hyperuricemia in patients with different forms of nephrolithiasis using allopurinol and Allomaron]. / Korrektsiia giperurikemii u bol'nykh s razlichnymi formami nefrolitiaza allopurinolom i allomaronom.

Metabolic status was assessed in 48 patients with nephrolithiasis followed-up for 4 years. Allopurinol and allomaron-treated patients were examined biochemically by 17 parameters of the blood and urine. The effects of the drugs were compared. It is concluded that in hyperuricemia up to 0.37 +/- 0.02 mmol/l allomaron is more effective (1--2 pills a day). In higher hyperuricemia allopurinol is preferable (4 pills a day). Allomaron can be also used (1--2 pills a day) under the control of urinalysis.

[Ligenten--a combination drug with anesthetic and antibacterial action for local use in urology and gynecology]. / Ligenten--kombinirovannyi preparat s anesteziruiushchim i antibakterial'nym deistviem dlia mestnogo primeneniia.

Ligenten gel is a combined dosage form containing gentamicin (a broad spectrum antibiotic), lidocaine (an anesthetic) and ethonium (an antiseptic). The hydrogel sodium carboxymethylcellulose in combination with polyvinylpyrrolidone is used as the ligenten base. The clinical trials in urologic and gynecologic patients showed that ligenten had a high therapeutic efficacy in the treatment of inflammatory diseases, as well as an anesthetic action in instrumental examinations and surgical endoscopic manipulations.

[The differential microbiological diagnosis of bacteremia and sepsis and the results of its practical use]. / Differentsial'naia mikrobiologicheskaia diagnostika bakteriemii i sepsisa i rezul'taty ee prakticheskogo ispol'zovaniia.

A rapid method for the detection of classical forms of bacteria and their cell-wall defective (CWD) variants in the blood has been developed and approved. The method is based on the kinetic analysis of bacterial growth with the use of nephelometry. The analysis lasts 3-10 hours. The method permits the differential microbiological diagnosis of bacteremia and sepsis, as well as the rapid control of the effectiveness of antibacterial therapy. The rapid method has revealed that in the presence of antibacterial therapy infective agents persist in the blood as CWD variants and not in the classical bacterial form, which sharply decreases the reliability of the traditional diagnostic method. CWD variants have been detected in the blood of patients treated with the preparations of cephalosporin, chinolon, aminoglycoside, dioxydin, etc.

[Accelerated elimination of the stone fragments after extracorporeal shockwave lithotripsy]. / Uskorenie éliminatsii fragmentov kamnia posle distantsionnoi udarno-volnovoi litotripsii.

As shown in experiments on 40 Chinchilla male rabbits, sinusoidal modulated currents (SMC) and ultrasound (US) are able to enhance bioelectrical activity of the ureteral smooth muscles. Activation of the muscular wall biopotential is followed by 0.15-0.2 s contraction. The above effect was used by the authors in rehabilitation of 120 patients after ECIL. SMC and US were included into the physiotherapeutic complex. The above patients whose concrements after the fragmentation diminished to less than 7 cm in size were divided into 2 groups. Sixty patients of group 1 received spasmolytic drugs, sodium chloride or iodine-bromine baths and dynamic amplipulse therapy. Sixty patients of group 2 in addition to the above treatment were exposed to local vibration and US. All the patients were given antibacterial drugs. The percent of patients with complete urolith evacuation in group 1 amounted to 91.7%, with partial evacuation 8.3% (96.7 and 3.3% in group 2, respectively). Dynamic nephroscintigraphy demonstrated that after relevant physiotherapy renal function improved, leukocyte and red cell count in the urine and ferrum, alkaline phosphatase levels in the serum decreased.

[The clinical efficacy of the new drug agent ligentén in urology patients]. / Klinicheskaia éffektivnost' novogo lekarstvennogo sredstva ligenténa u urologicheskikh bol'nykh.

A clinical trial was made of a new gel ligenten intended for local urethral anesthesia and treatment of infection and inflammation in the lower urinary tracts. Ligenten was given to 52 patients to manage bladder, prostate, urethral infection and inflammation, for local prophylaxis before cystoscopy, urethral bouginage and transurethral surgery. Apparent advantages of intraurethral introduction of the analgetic compared to instrument lubrication are demonstrated. Ligenten was also effective against chronic cystitis, cystalgia and urethral syndrome in females, especially in ulcerative cystitis. The gel exhibited adequate antiinflammatory and analgetic effect. As a prophylactic means, it prevents inflammation in cystoscopy, urethral catheterization and transurethral operations. No severe side effects have been reported.

[The prevention of infectious-inflammatory complications in the postoperative period in percutaneous surgical interventions in patients with urolithiasis]. / Profilaktika infektsionno-vospalitel'nykh oslozhnenii v posleoperatsionnom periode pri perkutannykh khirurgicheskikh vmeshatel'stvakh u bol'nykh s mochekamennoi bolezn'iu.

The paper describes a number of modifications in the operative procedures, pre-, intra- and postoperative antibacterial treatment introduced to decrease the number and severity of infectious-inflammatory complications of endourological surgery for urolithiasis; presents the results of anti-bacterial prophylaxis of urinary infection aggravation in 29 patients suffering from urolithiasis combined with renal anomalies. Antibacterial treatment was performed with ftorquinolone drug ciprinol (ciprofloxacin hydrochloride) made in Slovenia. 18 patients received ciprinol twice a day at a dose 500 mg 3-5 days before the operation and within 5-7 postoperative days. The other 11 patients received the drug intravenously (100 mg in drops) in parallel with initial anesthesia and during 1-2 postoperative days. It was continued orally within the next 5-6 postoperative days. The analysis of ciprinol pharmacokinetic profile showed its concentrations in the blood and urine to surpass minimal inhibitory concentration for the majority of the isolated microorganisms. Out of 18 patients treated with oral ciprinol, postoperative aggravation of pyelonephritis occurred in 3 (16.7%) versus 8 (40%) cases out of 20 controls. 11 patients on intravenous ciprinol developed no complications. The conclusion is made on high efficacy of preoperative antibacterial preparation and of intraoperative antibacterial therapy continued for some time after the surgery in cases of percutaneous endoscopic surgical interventions for urolithiasis attended by chronic urinary infection. The antibacterial treatment brings about a 2-3-fold decrease in the occurrence of postoperative inflammatory complications.

[The suppression of the Ca ATpase activity of rat kidney microsomes under the action of blood plasma as an index of the severity of the status of pyelonephritis patients]. / Ugnetenie Ca-ATFaznoi aktivnosti mikrosom pochek krys pod deistviem plazmy krovi kak pokazatel' tiazhesti sostoianiia bol'nykh pielonefritom.

Whether blood plasma from 63 pyelonephritis patients can inhibit Ca-ATPase activity when compared to known toxicity marker (middle-sized molecule number) was studied. This was done to assess diagnostic potentialities of the test based on the ability of plasma from pyelonephritis patients to inhibit the test enzymatic system, i. e. Ca-ATPase activity of the microsome fraction from renal cortex in intact rats. The inhibition of Ca-ATPase activity by the plasma is shown to correlate with inflammation activity and the patients condition. In pyodestructive acute pyelonephritis this inhibition reached 60.6 +/- 3.86%, in acute serous pyelonephritis 36.02 +/- 1.54%. It follows, that the above parameter is more informative than the number of middle-sized molecules and can be introduced as one of the criteria of the patients' condition and for choice of treatment.

[A method for revascularizing the penis]. / Sposob revaskuliarizatsii polovogo chlena.

The authors propose an original method of vasculogenic impotence surgery involving correction of arterial and arteriovenous insufficiency of the penis. This includes isolation of penile dorsal artery and deep dorsal vein in the proximal and middle third, then of the low epigastric artery along the entire length from the branching to the distal third. Upon establishing the shunt from the dorsal artery and vein, it is sutured with epigastric artery end-to-side. The procedure ends by placing the deep dorsal vein into the duplicature of the corpus cavernosum tunica albuginea. Follow-up results (within 3 years) available for 12 surgical patients demonstrate that improvement did not occur only in one case. This patient had corpus cavernosum sclerosis.

[Regulation of prostatic growth, pathogenesis of prostatic adenoma and cancer]. / Reguliatsiia rosta predstatel'noi zhelezy, patogenez adenomy i raka predstatel'noi zhelezy.

This review discusses the molecular mechanism of the regulation of prostate growth, maintenance of the prostate integrity and possible disturbances in these processes leading to the development of prostatic cancer and benign hyperplasia. The role of hormones, growth factors, oncogenes is described in more details. The participation of the angiotensin converting enzyme and renin-angiotensin systems in the regulation of polyamine synthesis in the prostate and the regulation of prostate growth is assumed.

[The efficacy of Ligenten gel in the prevention and treatment of infectious-inflammatory diseases of the urogenital organs]. / Effektivnost' gelia Ligentena pri profilaktike i lecheniia infektsionno-vospalitel'nykh zabolevanii mochepolovykh organov.

A new therapeutic in the form of a gel named ligenten was studied. The gel active components are lidocain, gentamicin and ethonium. Ligenten was shown to have a marked local anesthetic action when administered transurethrally. As a prophylactic agent the gel was highly active against the majority of the causative agents of renal infections due to cystoscopy, catheterization and bougienage of the urethra. Ligenten provided a sufficient anesthetic effect in transurethral operations but did not prevent superinfection due to the hospital strains. Marked antiinflammatory and reparative actions of the gel especially in the treatment of ulcerous cystitis were observed.

[Clinical efficacy of cefixime (results of multicenter trials)]. / Klinicheskaia éffektivnost' tsefiksima (rezultaty mul'titsentrovykh ispytanii.

Multicentre trials of cefixime (Cefspan, Fujisawa Pharmaceutical Co., Ltd., Japan) were performed in 1992. The trials involved 137 children and 269 adult patients with inflammatory infections of the respiratory organs and urinary tracts and otorhinolaryngologic affections. Positive clinical and bacteriological results of the trials were stated in 76-90 per cent of the cases. The adverse reactions such as skin eruption and dyspepsia were rare and did not require the specific treatment.

[Acupuncture in the combined treatment of pyelonephritis]. / Akupunktura v kompleksnom lechenii pielonefrita.

In the treatment of pyelonephritis which continues to cause problems in practical uronephrology, the main efforts of the clinicians are now directed at enhancement of the patients resistance, improvement of renal blood flow and urodynamics. Acupuncture (AP) is thought capable to meet the above requirements. It was used in combined treatment of 102 pyelonephritis cases (51 with acute and 51 with chronic manifestations) showing intact renal function. According to radionuclide renography, a positive trend in the secretion and urodynamics of the upper urinary tract was demonstrable in 50% of the patients. Dynamic nephroscintigraphy reported a positive response in 60% of cases versus 25% in those treated without AP. AP promotion of earlier recovery or remission, reduction of the scope of chemotherapy, good short- and long-term response permit this modality to be recommended for application in urological and nephrological practice.

[Content of vitamins E and A in tumor tissue in kidney cancer]. / Soderzhanie vitaminov E i A v opukholevoi tkani pri rake pochki.

Vitamin E was quantified in tumor tissue obtained from 17 patients with renal cell carcinoma (RCC). The tumors consisted of two groups: (I) represented primarily by clear cells (10 cases) and (II) without predominant appearance of those cells (7 cases). Vitamin E concentration in tumor tissue was compared with that in intact tissue sites of the kidney. The vitamin content in intact renal medulla was shown to be 1.5 times higher than in intact cortex. Vitamin E level in group I tumors was shown to be on average 15 and 10 times as much as in intact renal cortex and medulla, respectively. The vitamin concentration in group II tumors, as compared with the above intact renal tissues, was 7- and 5-fold higher, respectively. In spite of the high tumor total lipids levels, the vitamin E concentration, calculated per mg total lipids, was still higher in tumor tissue than in the normal renal tissues. This finding was especially demonstrable for the group I tumors. In the benign renal tumor angiomyolipoma vitamin E concentration, calculated on a wet weight basis, was higher than in intact renal tissue, but no differences were observed when a per total lipids calculation was performed. Vitamin A concentration determined in the tumor samples obtained from 6 patients was the same as in intact cortex.