The authors determined activity of leucine arylamidase (LA) or microsomal aminopeptidase locating in tubular cell microsomes and as a specific enzyme indicating parenchymal damage in the urine of 28 healthy subjects and 187 patients with nephroliths (103), renal injury (13 contusions, 11 rupture) before and after extracorporeal lithotripsy. Changes in LA were followed up spectrophotometrically. LA levels in healthy controls, nephrolithiasis patients free of pyelonephritis or with it in remission were similar, elevated in latent course and significantly elevated in complicated by inflammation nephrolithiasis, renal injury and in patients with associated pyelonephritis after lithotripsy. The highest LA activity was recorded in patients with renal injury and after lithotripsy with latent or active inflammation before lithotripsy. LA urinary content may serve indication of inflammation in the kidneys, parenchymal involvement. It is a helpful adjuvant diagnostic method in urology.

Clinical Enzyme Tests↗

PubMedDate not supplied

[The postgraduate education of urologists in the Russian Federation].

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Curriculum↗

PubMedDate not supplied

[The intraoperative ultrasonic control of the radicalness of transurethral resection in bladder cancer].

72 patients with bladder cancer stage T1, T2 underwent transurethral resection of the bladder wall affected with tumor under ultrasound control of the removal radicality. The evidence obtained at transurethral ultrasound scanning was compared to the findings of histological examination of the tissue removed. The accuracy of the control made up 87.3%. This made it possible to follow tumor invasion from the tumor margins along the periphery in accordance with blastomatosis stage. The authors have developed a technique of transurethral resection of bladder wall under transurethral ultrasonic scanning as control of the removal radicality.

Evaluation Studies as Topic↗

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[The role of ultrasonic study in the diagnosis of the multilocular kidney cyst].

The paper reports 5 cases of rare renal disease, multilocular cyst. Pathogenetic, pathomorphological, clinical and visual diagnostic aspects of the cyst presented in the literature are reviewed. Special emphasis is placed on diagnostic potential of ultrasound investigation. Current values of computed tomography and conventional X-ray urological techniques, difficulties in differential diagnosis of multilocular cyst with other cysts and renal carcinoma are shown. The authors think it valid to use combined radiological methods in determination of pathological process origin and its details, calcificates, in particular.

Adult↗

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[The effect of remote-controlled shock-wave lithotripsy on kidney function].

Leucine arylamidase (LAA) excretion in circadian urine of 79 patients suffering from nephroureterolithiasis was measured before and after the session of remote impulse lithotripsy (RIL) to investigate the effect of the impulse on renal function. The stones were localized in the calyces, pelvis and upper third of the ureter. The patients were divided into 2 groups: 43 patients with noncomplicated nephroureterolithiasis (group 1) and 36 patients with complicated one including 12 subjects exposed to the second RIL (group 2). The enzyme excretion was significantly reduced in group 1 patients. Its activity recovered in group 1 within 6-7 days, in group 2 for 10-14 days. After the second RIL procedure LAA activity in the urine enhanced more rapidly, especially in group 2 patients. In calyceal, intrarenal pelvic and fused kidney location of the stone, LAA activity got more elevated than in the extrarenal pelvis or in the upper third of the ureter. It is demonstrated that RIL exhibits a short-term effect on the kidneys which depends on the presence of inflammation, the number of sessions, stones location and the number of impulses.

Adolescent↗

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[The effect of the physicochemical structural properties of urinary calculi on the results of extracorporeal shockwave lithotripsy].

The relation of chemical composition and structure of uroliths to lithotripsy effects was evaluated with regard to the concrement size, location, time of the intraureteral persistence, etc. Besides, a prognosis of the remote impulse lithotripsy (RIL) outcome was attempted by x-ray picture and crystallization alterations in the urine. 54 patients with nephroliths and 73 patients with ureteroliths (overall 137 concrements) were examined. By RIL results, the patients were divided into 2 groups: those who benefited from RIL and those who failed it. Worse results were obtained in cases of oxalate concrements with radial-concentric structure and with phosphate ones composed primarily of hydroxylapathite. RIL efficacy was found to depend on a number of interrelated factors (chemical structure, location, size of the concrement, duration of its existence in the ureter). In long-standing ureteroliths the outcomes are associated with stone structure. The denser is the concrement the more probable is its strangulation and more apparent is periureteritis. Changes in crystallization can prompt RIL prognosis as well as it is possible by x-ray picture.

Adolescent↗

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[The treatment of patients with benign prostatic hyperplasia with Proscar MSD (finasteride)].

53 patients have undergone 1-year conservative treatment of benign prostatic hyperplasia with the drug proskar MSD. All the patients had the disease stage I-II, maximal urination rate at least 5 ml/s, residual urine to a maximum 150 ml. Benign nature of the disease was confirmed by the test with prostate-specific antigen. Selection of patients, follow-up and assessment of treatment results were conducted according to the scale of the International System of Overall Assessment of Prostatic Lesions. Proskar MSD was found active in benign prostatic hyperplasia basing on the shifts in the main three indices (symptom status, maximal urination rate, prostate size).

Aged↗

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[Conservative surgery in tumors of the renal parenchyma].

Policy in diagnosis and conservative therapy of renal parenchyma tumors is considered for bilateral lesion, single kidney, combination of renal tumor with renal failure, small-size tumors in normal renal function. The authors advocate all kinds of renal resection. Enucleation is feasible in the single kidney having encapsulated tumor of 3 and less cm in size.

Biopsy, Needle↗

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[Cyproterone acetate (Androcur-depo) in the treatment of inoperable prostatic cancer].

The authors consider fundamentals of hormone therapy in prostate cancer, mechanism of long-term androgenic stimulation, detail mechanism of action of antiandrogen (ciproteron acetate-androcur) on the basis of discovered key role of cellular receptor in endocrine regulation of physiological functions in metabolism. Monotherapy with androcur-depo (300 mg once a week) was given to 24 patients with prostatic cancer stage T2-T4. Eight patients had metastases to the bones. The age of the patients ranged from 58 to 80 years. Alleviation of pain, reduction of the prostate size and density, positive uroflowmetric changes (maximal urination rate increased from 2-5 to 10-15 ml/s), residual urine fall occurred as early as treatment week 5-7. There was also a decrease in the activity of acid phosphotase from 5-10 to 0.3-0.8 units according to Bodansky. Serum level of prostate-specific antigen (PSA) dropped from 388-23 to 116-4 ng/ml. Androcur-depo monotherapy demonstrated high efficacy in the treatment of local prostatic cancer.

Aged↗

PubMedDate not supplied

[Role of radiographic signs of urinary calculi in the effectiveness of extracorporeal shock-wave lithotripsy].

The value of X-ray signs of urinary calculi for the efficiency of shock-wave teletripsy (SWTL) was assessed in 188 patients with nephro-ureterolithiasis. The calculi were studied from the general X-ray film by means of a routine 4-5x magnifier. All the patients were divided into 2 groups. Group 1 comprised patients with effective SWTL, i.e. those undergone 1 or rarely 2 sessions. Group 2 included those with low effective SWTL, 2-4 sessions. Comparative analysis of X-ray films indicated that the calculi which were homogeneous in structure, moderate in intensity and had even edges in the general X-ray pictures in 154 (82%) cases were fragmented after 3-4 sessions (the average number of impulses were 7500, at 19.0 kV). With their heterogeneous structure, low and high intensity, irregular rough edges, they were fragmented after 1 or rarely 2 sessions in 34 (18%) patients. The number of impulses was fewer, on an average of 2300, the voltage was less -17.5 kV. It was noted that the pattern of the edges of a calculus and its geometric form are of highly value in the prediction of SWTL. Calculi having even edges were more frequently encountered in patients from Group 2 (in 81.1% of cases), but in patients of Group 1 they were only in 18.1%.

Adult↗