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Biomedical subjects

E K Ianenko

Publications and source records attributed to E K Ianenko.

At least 19 recordsLinked to original sources

[Occlusive factor in development of urolithiasis complications].

Causes and mechanisms of complications in urolithiasis are analysed with a focus on the role of occlusion of the urinary tracts in the onset of pyoseptic complications. Most severe of them is bacteriotoxic shock which is hard to treat and dangerous for essential body functions. The priority of the treatment must be reestablishment of urine passage. Additional tools of the treatment include wide-spectrum antibiotics, efferent detoxication, electrochemical blood oxidation, hyperbaric oxygenation, UV blood radiation.

Anti-Bacterial Agents↗

[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↗

[Risks and complications of surgical treatment of urinary lithiasis of single kidney].

163 patients with urolithiasis of the solitary kidney were treated surgically. Analysis of causes of postoperative complications (n = 70) and lethal outcomes (n = 11) demonstrate that lethal outcomes were in many cases related to exacerbation of renal failure, acute calculous pyelonephritis which had provoked sepsis and bacteriotoxic shock, acute hemorrhage with hemorrhagic shock followed by development of DIC-syndrome.

Acute Disease↗

[Ways of improving preparing research and teaching personnel and clinicians in urology in the Russian Federation].

The article covers basic principles of urologists' and researchers' training for state healthcare system. The role of a student research group in proper students selection for further special education in urology is pointed out. The article contains a plan of training in clinical residency including theoretical basis of urology and allied fields, diagnostic tools and practical skills, especially in urgent cases. The principles of postgraduate research personnel training in the field of urology are highlighted also. Special attention is paid to regional specialists training. The residents in surgery are preferred for further training in urology.

Curriculum↗

[Urinary tract occlusion: a principal cause of some complications of urolithiasis].

Urinary tract occlusion in urolithiasis is a serious complication which provokes an attack of acute obstructive pyelonephritis. The infected urine aggravates this infectious-inflammatory process and endangers bacterial shock. Etiopathogenesis of this shock is outlined and modern approaches to its management are described.

Acute Disease↗

[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↗

[Results of surgical treatment of coral nephrolithiasis].

A total of 98 patients (39 males and 59 females) with coral nephrolithiasis (CN) were divided into 3 groups depending on the variant of surgical treatment. The results were followed up for 5 years. Group 1 and 2 patients have undergone combined low-traumatic open surgery or low-invasive interventions (extracorporeal lithotripsy--ECL or percutaneous nephrometolapaxy--PN), group 3 patients--open surgery (pyelonephrolithotomy or section nephrolithotomy. It was found that the treatment was longest in group 1 and shortest in group 3, complications occurred most frequently in group 3 on section nephrolithotomy, least frequently in group 2. A significant decline of operated on kidney late after the treatment was observed in patients subjected to section nephrolithotomy. Thus, ECL and PN produce positive results in patients with CN (elimination of the stone with a minimal risk of residual concrements) in good long-term function of the operated on kidney.

Adult↗

[Upper urinary tract hypertrophy of the solitary kidney].

17 dogs were examined 1 and 3 months, 1-1.5 years after unilateral nephrectomy. It was found that compensatory hypertrophy develops not only in the parenchyma of the remaining kidney but in the upper urinary tracts as well. 1 month after the nephrectomy ureteral activity for urine evacuation enhanced as compared to its preoperative activity. 3 months and 1-1.5 years after the nephrectomy ureteral performance remained elevated. High performance was supported due to increased amplitude of the contractions and their prolongation. Frequency of the contractions reduced. Basal and peristaltic pressure in the ureter, as a rule, rose. Diuretic lazix load 3 months after nephrectomy and more led to higher elevation of the intraureteral pressure. Ureteral wall lock in contraction promoting active urinary transport was observed whereas this locking mechanism before nephrectomy was decompensated even in lower intraureteral pressure. Ureteral hypertrophy was followed by negative effects such as defective generation and conduction of excitation through the ureter, higher incidence of endogenous infection in the urinary tracts.

Animals↗

[The prevention and treatment of complications from extracorporeal lithotripsy].

Since October 1987, remote lithotripsy (RL) has been performed at the Research Institute of Urology, RSFSR Ministry of Health, over 3 years. "Specific" complications associated with RL made with a Urat-P lithotriptor are common in the immediate period following the procedure. The paper describes the analysis and outlines complications, causes of their occurrence, and prophylactic measures. A total of 2,300 lithotripsies conducted in 1988-1990 were analyzed. The incidence of the complications was 2.4%, which is similar to the values observed with foreign lithotriptors. The occurrence of acute pyelonephritis caused by RL is likely to increase when there is a baseline active inflammatory process in the urinary tract. The paper proposes a procedure for selecting patients in RL, antibacterial preoperative therapy, methods for lithoclasty with the use of the national lithotriptor. Involving two lithotripsy regimens. The authors find it necessary to drain the urinary tract within the first days of the appearance of signs of acute pyelonephritis by renal catheterization or paracentetic nephrostomy.

Acute Disease↗

[Ultrasonic study of the parathyroid glands in patients with coralliform nephrolithiasis].

Functional activity of the parathyroid glands (PTG) is important for the choice of proper therapeutic policy in patients with dendritic nephrolithiasis. The location of the hyperfunctioning gland (usually adenomatously or hyperplastically changed) is a complicated problem as the dimensions of the gland are extremely small. Ultrasonic investigation of the parathyroid gland area for detection of the enlarged gland is used at the Research Institute of Urology, the RSFSR Ministry of Health. Linear (7.5 mHz) and sector (5 mHz) transducers have been used through the water medium and by the immediate contact with the surface of the patient's neck. A total of 24 subjects were enrolled in the study (13 females and 11 males aged 23-64 years). Enlarged parathyroid glands situated in the lower thyroid lobe (low parathyroid glands) or in the upper medial third of the thyroid lobe (upper parathyroid glands) were recorded in 9 patients and confirmed in the course of surgeries. In one case, the enlarged parathyroid gland was found in the thyroid tissue. Its length varied from 0.6 to 1.5 cm and its thickness, from 0.4 to 0.9 cm. All the glands were echographically evidenced as oval formations with a low-rate echogeneity and clear-cut smooth contours. In 3 cases the site of the gland was confirmed by a selective testing of the neck venous blood for parathyroid hormone. Histological examination of the removed glands revealed that hyperplastic changes were more common than the adenomatous ones.

Adenoma↗