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Biomedical subjects

N K Dzeranov

Publications and source records attributed to N K Dzeranov.

At least 19 recordsLinked to original sources
PubMed1989

[Shockwave destruction of stones in the kidneys and ureters].

Experience gained in the use of the first Soviet unit and western lithotriptors is based on the treatment of over 2500 patients of different age groups. Comparative characteristics of lithotriptors are provided to mark substantial advantages of the Soviet unit. Distant lithotripsy (DL) is much more effective and atraumatic as compared with conventional surgical interventions. The use of DL provides positive effect in 97-99% of cases. The rate of complications is extremely low, amounting to 5-10%. Indications and contraindications as to the use of DL are given. Contraindications include cases requiring reconstructive surgical interventions and the presence of coral-like calculi and acute inflammation. The Soviet unit appeared especially effective in the treatment of children with urolithiasis. The cure was attained in 97.2% of the patients, no serious complications occurred. Functional studies of the kidneys did not reveal any changes both in the short- and long-term periods after DL.

Adolescent↗
PubMedDate not supplied

[Effects of focused shock waves on children's kidney: experimental study].

The effects of focused shock waves produced by URAT-P2 unit on renal tissue was studied in 120 immature rats with 100-120 g b.w. Morphological material obtained after the procedure and 3 months after it was studied with reference to the following parameters of the impact: interelectrode spacing, capacitor capacitance, capacitor charging voltage, pressure in the therapeutic focus, number of impulses. It was found that one of the essential damaging factors of the shock waves is spontaneous widening of the interelectrode spacing in the course of the fragmentation which entails an increase in the pressure amplitude in the center of the therapeutic focus with resultant prolongation of the impulse.

Aging↗
PubMedDate not supplied

[Extracorporeal shock-wave lithotripsy (ESWL) in removal of stones in anomalies of kidney and upper urinary tracts].

The authors analyze the results of ESWL (URAT-P unit) for urolithiasis performed in 106 patients (49 females and 57 males) aged 16-67 years with anomalous kidneys and upper urinary tracts. 28, 1, 11, 14, 24, 4, 22 and 2 patients had horseshoe, L-shape, solitary, lumbar distopic, double, sponge, cystic kidneys, congenital megacallicosis, respectively. The stones ranged in size from 7 to 30 mm. Bilateral urolithiasis was in 7 patients. The number of impulses averaged 1745 +/- 168.4 per the procedure. The average number of ESWL procedures per stone was 1.4 (1-4). The stones were completely eliminated after one ESWL session in 78(73.6) patients, after two sessions in 23(21.7%) patients, after three sessions in 4, after for in 1 patient. Complications developed in 18 patients: urinary tract obstruction and attack of acute pyelonephritis (15 and 3 patients, respectively). Within 2-10-year follow-up recurrences arose in 12 patients who were retreated. Thus, ESWL is a method of choice in the treatment of urolithiasis patients with malformations of the kidneys and upper urinary tracts. Good results of ESWL are achieved in strict adherence to principles of the patients' selection, preoperative preparation technique, individual approach to patients in postoperative period, follow-up to detect complications and recurrences.

Adolescent↗
PubMedDate not supplied

[Recurrence-free and recurrent urolithiasis: metabolic differences].

Biochemical tests by 12 metabolic blood and urine indices reflecting the condition of renal function and metabolism of urolithogenic substances were made in the course of 1-6 year follow-up of 35 and 79 patients (46 females and 68 males aged 18-65 years) with recurrence-free and recurrent urolithiasis, respectively. The risk of recurrence for uric acid urolithiasis in serum concentration of urea 5.67 +/- 0.14 mmol/l and creatinine 0.090 +/- 0.008 mmol/l, in hyperuricemia and hyperuricuria was associated with elevation of renal excretion of total calcium to 5.88 +/- 0.49 mmol/day and ratio of daily renal excretion of sodium to renal daily excretion of potassium to 3.28 +/- 0.08; for calcium-oxalate lithiasis--with a rise in serum concentration of uric acid to 0.310 +/- 0.042 mmol/l and sodium to 114 +/- 0.8 mmol/l in hypercalciuria and hyperuricuria.

Adolescent↗
PubMedDate not supplied

[Functional state of upper urinary tract in urgent extracorporeal lithotripsy].

Seven patients have undergone urgent extracorporeal lithotripsy (UEL) for renal colics. 3 patients were cured. Before UEL they had insignificant defects of urodynamics and ureteral contraction. 3 patients with initial dilation of the upper urinary tracts > 2 cm and reflux ureteral motility, residual concrements eliminated spontaneously or after additional UEL procedures or combined treatment. One female with initial pelvic and uretral dilation and disturbed motility of the upper urinary tracts was treated for 6 months. 1-2.5-year follow-up detected neither concrements nor marked dilation of the calyceropelvic system. Patients with renal colics have more pronounced local defects of contraction rhythm and activity, peristaltic direction. Peristaltic disorders in the upper urinary tracts in patients with renal colics are local and may be related to acute occlusion and neuroreflex effects. This explains why UEL produces good results in renal colics, especially in patients with minimal defects of urodynamics. Complicated course after UEL early after the operation occurred in patients with dilated upper urinary tracts, high contraction amplitude registered by high tonicity of the ureteral wall and the presence of retrograde peristaltic waves.

Humans↗
PubMedDate not supplied

[Effects of mineral water TIB-2 on metabolic processes in urolithiasis patients].

Natural low-mineralized hydrocarbonate-calcium-magnesium mineral water (total mineralization 2 g/l) in bottles has been examined for therapeutic effects on metabolism in urolithiasis patients. The complex of biochemical blood and urine indices indicative of the renal function and concentration of lithogenic components was studied in 52 patients (age 23-68 years, 23 males and 29 females). Ten of them had nephrostoma. All the patients have undergone extracorporeal lithotripsy or other operations for renal or ureteric calculi. In nephrostoma patients urine samples were obtained both from nephrostoma and urinary bladder. The tests were made before the treatment and on the treatment day 3-5 and 10-12. TIB-2 mineral water was taken 3 times a day in a dose 200 ml 30-45 minutes before meal. The data were statistically processed. From the data obtained it was concluded that mineral water TIB-2 normalizes azotemia and clearance of endogenic creatinine, plasma values of calcium and uric acid, enhances urinary elimination of uric acid and calcium oxalate microcrystals that is TIB-2 improves metabolism of lithogenic substances and ions. Indications to drinking mineral water TIB-2 for urological patients are formulated.

Adult↗
PubMedDate not supplied

[Role of biochemical methods in follow-up and treatment of patients with urolithiasis].

4-6-year follow-up using different tests covered 15 patients with urolithiasis and 11 control subjects aged 25 to 66 years. All the patients underwent 1 to 5 sessions of extracorporeal lithotripsy and one patient underwent open surgery. Clinical and biochemical findings on the groups were compared to the evidence of Litos test. Initiation of antirecurrence therapy should be based on the information gained with different methods, primarily, biochemical. Follow-up of the patients including biochemical control over their metabolic condition must be conducted for at least 5 years.

Adult↗
PubMedDate not supplied

[Initial results of the clinical use of a novel Russian lithotriptor LitURAT-UR].

By its performance characteristics LitURAT-UR lithotriptor is different from previous units made in Russia or abroad. Besides the double stone-directing system (ultrasound + x-ray), LitURAT-UR is furnished with two interchangeable generators of shock-wave impulses (electrohydraulic and electromagnetic) allowing effective destruction of any urolith. The TV system is able to control the interelectrode space and to change it in the course of lithotripsy. Efficiency of the new lithotriptor in different clinical forms of urolithiasis reached 93.1%. Thus, universal, effective and low-traumatic characteristics of the lithotriptor LitURAT-UR hold much promise for urological practice in Russia.

Adolescent↗
PubMedDate not supplied

[Effects of impaired urodynamics and contractile function of the upper urinary tract on elimination of stone fragments after extracorporeal lithotripsy].

The authors analyze effects of amplitude, tone and frequency of ureteral contractions on elimination of stones fragmented after extracorporeal shock-wave lithotripsy (ECSWL) in 30 patients with concrements in the kidneys and ureters. Before ECSWL the patients had indications for renal pelvis cathetarization. The measurements were made with multichannel impedance ureterography. According to initial dilatation of the upper urinary tracts (UUT), the patients were divided into 3 groups. It is shown that urodynamic UUT disorders determine effectiveness of ECSWL in urolithiasis patients: the greater is the dilatation the more probable are unsatisfactory results of ECSWL. Ureteral contractile activity is essential for rehabilitation in early postoperative period after ECSWL in patients with unrevealed UUT dilation: high amplitude of ureteral contractions in low tone is good for the fragments elimination, while high tone may result to the fragments ejection into the kidney. Low contractility may contribute to development of stone path. In patients with pronounced UUT dilation ureteral contractility is less important for ECSWL effectiveness than the wall tone and retrograde ureteral peristaltic movements. ECSWL results are better in patients with low tone of UUT wall. High UUT tone, especially in combination with retrograde peristaltic ureteral contractions registered prior to ECSWL indicates high probability of residual stones and additional fragmentation procedures irrespective of initial UUT dilation.

Data Interpretation, Statistical↗
PubMedDate not supplied

[Results of clinical use of the polyfunctional lithotripsy device "Dornier-U 50"].

The review of the results of clinical application of a polyfunctional lithotriptor Dornier-U50 in urolithiasis patients is presented. The treatment of 324 patients produced good results of lithotripsy in uroliths of any location in generating high-energy shock waves. Complete fragmentation was achieved in 86.4%, partial one--in 11.7%. Complications occurred in 9% of which 5.3% were cases of upper urinary obstruction. The Dornier-U50 lithotriptor can be used for both extracorporeal lithotripsy (under x-ray and ultrasound targeting) and various endoscopic operations under x-ray telecontrol. This allows maximal utilization efficiency of this equipment in diagnosis and treatment in urological hospitals.

Humans↗
PubMedDate not supplied

[Long-term results of treating children with kidney and ureteral stones with extracorporeal lithotripsy].

Long-term outcomes of urolithiasis treatment with extracorporeal lithotripsy (ECLT) have been analysed for 132 children using, as the basic criterion, data of dynamic nephroscintigraphy. The results of ECLT were considered regarding characteristics of the concrement, inflammatory process, parameters of the shock wave. It was found that low-energy restruction regimens in minimal number of impulses per session and adequate intervals between them prevent irreversible changes in renal parenchyma in response to focused shock waves. Monitoring and adequate treatment late after ECLT lead to recovery of renal function if obstructive complications and stone formation are found early and if the course of the inflammation is controlled.

Child↗
PubMedDate not supplied

[Complications of open surgical procedures in urolithiasis and their prevention].

236 operative interventions for urolithiasis have been performed in 234 patients. Of them, 187 (79.9%) patients developed complications. Intraoperatively complications resulted from opening of the pleural and abdominal cavities (20 patients, 8.5%) and intraoperative blood loss < 500 ml (19 patients, 8.1%). In one case a nephrectomy was made because of repeated hemorrhage early after the operation. Among the postoperative complications most frequent were acute pyelonephritis (34, 14.5%) and aggravation of renal failure (11, 4.7%). The former demanded extracorporeal detoxication in 9 cases, in the latter hemodialysis was not required. Residual comcrements occurred in 28 (12%) patients. 17 of them had to undergo extracorporeal lithotripsy. Thus, open urological interventions in urolithiasis are now conducted in advanced disease, provoking complications. This raises responsibility of the surgeons who must take maximal preventive measures and use novel technologies in management of the complications.

Adult↗
PubMedDate not supplied

[Residual kidney stones and their treatment].

416 case histories of patients with different forms of urolithiasis aged 6 to 70 years who had undergone sectional nephrolithotomy (83, 19.9%), pyelonephrolithotomy (24, 5.8%), pyelolithotomy (146, 35.1%), percutaneous nephrolithotomy (163, 39.9%) were analysed. Residual nephroliths occurred in 108 (25.9%) patients. 98 of them were subjected to extracorporeal lithotripsy (ELT). To determine minimal possible interval between the operation and ELT, changes in the levels of lipid peroxidation products and concentration of alpha-glutathione-S-aminotransferase were studied. The results allowed the authors to optimize ELT after operative interventions for uroliths. In the course of 206 ELT sessions the residual uroliths were destroyed in 96 (97.9%) patients. After one session a complete fragmentation was achieved in 19 (19.4%) patients, after two sessions--in 64 (65.3%) patients, after three sessions and more--in 15 (15.3%). Pyoinflammatory complications developed in 8 (8.2%) patients while retrospectively such complications were encountered in 16 of 50 patients (32%). One month after ELT, the control examination found neither nephroliths nor their fragments in 85 (86.7%) patients, in patients with large and multiple stones elimination rate 1.5 months after the treatment was 69.5%. It is inferred that ELT is an effective method of residual uroliths elimination and is a method of choice in the treatment of such patients.

Adolescent↗
PubMedDate not supplied

[Telelithotripsy in the treatment of staghorn nephrolithiasis in children using the URAT-P lithotriptor].

The paper presents the results of telelithotripsy monotherapy for 34 staghorn stones in 32 nephrolithiasis children carried out at the RSFSR Research Institute of Urology, Moscow. Commonest manifestations of the disease were leukocyturia (87.5% of cases) and Proteus bacteriuria (31.8% of cases). Basing on roentgenological findings, the stones were classified into 3 groups: initial (K1), incomplete (K2) and complete (K3). All the children underwent treatment on Soviet lithotriptor "URAT-P" under a delicate regime using different techniques of disintegration which started from the periphery and advanced to the pelvic part of the calculus. No pretreatment drainage of the pelvicaliceal system was performed. The intended staged disintegration of the stones was achieved in 94.2% of cases at 2.4 sessions, on the average, and overall number of impulses 1973.1 per each stone. At discharge 76.4% of the children were free of the main mass of the stone dust. Acute pyelonephritis which appeared the most frequent postoperative complication developed in 7.8% of the patients one of which required open nephrostomy and one percutaneous puncture nephrostomy. Other cases were treated by specific antimicrobial therapy. Complete series of investigations in the postoperative period did not reveal any intra- or pararenal hematomas. Radioisotopic renography revealed improvement in renal function in 62% of cases in early postoperative follow-up. Thus, 93.8% of children with stag-horn stones were spared of traumatic operative intervention or invasive manipulations. This makes the method of telelithotripsy a valuable therapeutic tool in childhood staghorn nephrolithiasis.

Adolescent↗
PubMedDate not supplied

[Operative treatment of kidney calculi].

262 cases of coral nephrolithiasis (CN) treated for the last 5 years (mean age 51.6 years) have been analysed. Of them, 46 (17.9%) patients have undergone 2 to 4 operations, 14 (5.4%) patients had bilateral nephrolithiasis. Open surgical interventions (section nephrolithotomy, pyelonephrolithotomy) were performed in 31 and 106 patients, respectively. All of them had a severe form K-3 or K-4. Extracorporeal shock-wave lithotrophy (ESWL) was conducted in 72 (27.5%) patients with coral concrements K-1, K-2. 'Mean number of the procedures per a stone was 4.2. Transcutaneous puncture nephrolithotripsy (TPNT) was made in 53 (20.2%) patients (K-2, K-3). The results of the treatment were assessed at discharge and 12 months after it. The efficacy of the treatment was judged by completeness of the stone elimination, postoperative complications and interventions to correct these complications. Open operations eliminated the stones completely in 71.2% patients, in combination with ESWL--in 91.6%, TPNT--in 78%, in combination with ESWL--in 94.5%. Efficacy of ESWL as monotherapy + stent reached 68.1%. Open operations entailed complications in 41.6% (of them 68.5% in section nephrolithotomy), TPNT--in 18.2%, ESWL--in 16.3%. Coral nephrolithiasis should be treated by skilled specialists in clinics furnished with modern facilities, combination of which minimizes traumatic complications and raises treatment efficacy.

Adolescent↗