Biomedical subjects
Publications and source records attributed to V G Kobets.
Glomerulonephritis with minimal alterations presents one of the most complex problems of nephrology. The authors provide the data on the disease incidence and clinico-laboratory correlations in 33 adult patients, discuss problems of the treatment policy.
The author relates the data on the time-course of changes in diurnal proteinuria, diastolic arterial pressure and blood creatinine in 123 patients with primary chronic glomerulonephritis seen during 159 pregnancies. The dependence of the character of those changes on the respective parameters before conception was analyzed as was such a dependence, in part of the patients, on the morphological disease pattern. The rise of proteinuria and diastolic arterial pressure during gestation was seen more often in women with initial diurnal protein losses exceeding 1g and with arterial hypertension that occurred before pregnancy. The rise of blood creatinine before conception was a prognostically unfavourable sign. Mesangiocapillary glomerulonephritis occurring in the gestation period is viewed as less favourable as compared to mesangioproliferative glomerulonephritis.
The authors studied the clinico-laboratory values and efficacy of pathogenetic treatment in 8 patients with primary segmental glomerulosclerosis and hyalinosis (PSGH). The disease is characterized by distinct disorders in the T-system immunity. Glucocorticoid treatment did not essentially effect the course of PSGH. Cyclophosphane treatment allowed to achieve essential stable clinical improvement in certain patients.
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The paper is concerned with clinico-laboratory correlations and assessment of short- and long-term results of glucocorticoid therapy (GCT) in 137 patients with diffuse mesangioproliferative glomerulonephritis (DMPGN). It may have different clinical variants and is characterized by a relatively favorable course in the first 10 yrs. A good clinical effect of GCT was observed only in some patients with the nephrotic variant of DMPGN in the absence or presence of insignificant fibroplastic changes, and in the absence or presence of the moderate tubulointerstitial component. In patients with a latent variant of DMPGN GCT made no considerable effect on the clinical symptoms of disease. The 15-year survival in patients on GCT was slightly higher (insignificant statistical difference) than that in patients receiving symptomatic treatment only.
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A stepwise development of the technique for the urine derivation into the artificial rectal urinary bladder was followed up. The cutting of the superior rectal artery and the vein which permitted one to form a rectal urinary bladder at the superampullar portion of the rectum turned to be the basic point of the technique development. A beneficial effect was achieved due to the extra-abdominal location of the rectal stump and the performance of ureterorectal anastomosis that minimized the hazards of urinary peritonitis development; the ligature of the superior rectal artery and vein decreased the resorption of the urine; lower mobilization and cutting of the rectum reduced surgery-related traumatism and enabled the surgeon to preserve the part of the sigmoid colon for its descending into the perineum. Based on the comparative evaluation of three modifications of the aforementioned technique, the authors made a conclusion that the derivation of the urine into an artificial rectal urinary bladder minimized the hazards of urinary peritonitis development and the occurrence of ascending pyelonephritis. X-ray and radionuclide investigations revealed recovery of the anatomical and functional status of the upper urinary tract in 75 per cent of the patients during 3-4 mos. The authors revealed insignificant changes in the values of nitrogen-excretory function of the kidney, glomerular filtration and tubular reabsorption in the immediate postsurgery period. Later on, these values approached those documented before the operation.
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