[Compression of the extrarenal blood vessels in kidney dystopia].
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Biomedical subjects
Publications and source records attributed to S Peneva.
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The authors observed two cases with crossed renal dystopia, to which venous urography, renal scintigraphy, echographic and gamma-chamber investigations were performed. The venous urography, in case of the appropriate symptomatics, is stressed to be able to establish the presence of heterolateral dystopia by as far as the distributional function of the anomaly is concerned--the gamma-chamber investigation is with the highest information value.
Lung ventilation was determined in 116 patients with various degrees of chronic renal insufficiency. The patients examined were subdivided into 4 groups according to the values of serum creatinine and glomerular filtration. Lung ventilation was increased in all patient groups, mainly on the account of the increased inspiration reserve volume. The changes in respiration rate were insignificant. PaCO2 values in arterial blood were adopted, by the author, as a sign of an existing hyperventilation. A high correlation interdependence was established between CO2 pressure in arterial blood (PaCO2) and the active blood reaction (pH). Considerably less was the correlation dependence between hyperventilation syndrome and the values of serum creatinine and blood urea.
A total of 116 patients with various degrees of chronic renal insufficiency were studied. The most frequent cause that led to its development was the chronic pyelinephritis, followed by chronic glomerulonephritis, and the other chronic renal disease, as--renal polycystosis, diabetic nephropathy, endemic nephropathy, etc. The dynamic and static pulmonary volumes volumes and capacities were investigated in order to achieve the task set and on their base--the type of ventilation disorder was determined. Certain changes of the indices were found in parallel with the intensification of the chronic renal insufficiency. They were best manifested in the patients with advanced renal insufficiency from II and IV group. Ventilation disorders were present in 50% of the patients examined. The restrictive type ventilation insufficiency was most often found (22.4%), second--the mixed type of ventilation defect (16.4%) and third--the obstructive type ventilation insufficiency (11.2%).
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The analytical diffusion capacity of the lungs was determined in 63 patients with various stages of chronic renal insufficiency. On the base of the values of serum creatinine and glomerular filtration the patients were subdivided into four groups. Considerable changes in all the three values of alveolar-capillary diffusion (DLCO, Dm, Vc) were established, with a definite parallelism between those changes and the chronic renal insufficiency stage. The most serious changes concern the membrane component. The correlation analysis confirms the presence of high reverse correlation interdependence, both with the values of serum creatinine and blood urea and with the diastolic arterial pressure.
The results are reported from the carried out 701 shortterm therapeutic courses in 527 patients with exacerbated chronic pyelonephritis. The results are considered as "very good" in realization of a full clinical remission (normalization of temperature and ESR), disappearance of leucocyturia and bacteriuria), "good" - in normalization of three of those indices and "withfut effect". Co-trimoxazol (88.3 per cent of the patients), gentamycin (61.7%), ampicillin (58.8%), nelidix acid (57.4%), nitrfuran (55.0%) and choloramphenicol (53.1%) have manifested the highest effectiveness (very good and good effect). In a small number of the treated patients with cephalosporins effect was obtained in 50.0 per cent, with urovalidin - 44.4 per cent and with carbenicillin - 62.5 per cent. According to the authors' opinion the therapeutic schemes for a long-term treatment must include chlorampheniacal, nelidix acid, co-trimoxazol and nitrofuran sometives -amplicillin. Gentamycin, ampicillin and cephalosporins and with indications - some other uroantiseptics must be used in the coping with severe exacerbation of the disease. The authors recommend the chronic intermittent uroantiseptic treatment.
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