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Aim: to determine main risk factors for complications of ureterolithotripsy., Materials and Methods: a retrospective analysis of the results of 545 ureteroscopies performed in 506 patients with ureteral stones over the past 7 years at the urological clinic named after M.F. Vladimirsky was carried out. The relationship between preoperative and intraoperative factors and complications of ureterolithotripsy was analyzed., Results: The overall complication rate was 22.4%. The risk of intraoperative complications was proved to increase (p<0.05) along with the stone size, location in proximal ureter, stone impaction for more than 3 weeks and the degree of hydronephrosis. No preoperative stenting or nephrostomy tube prior to ureteroscopy was associated to an increased risk of intraoperative complications (RR=2.88; p=0.03). Patients with preoperative drainage of upper urinary tract has lower probability of intraoperative complications (OR=0.35; p=0.03). The risk of developing stricture and ureteral obliteration in uncomplicated ureteroscopy was minimal (RR=0.008, p=0.0001). Small ureteral perforation and pronounced mucosal inflammation around the stone have the similar influence on the risk of complications, which was more than 7.5 times (p=0.0001) higher than in uncomplicated ureteroscopy. Large ureteral perforation was associated with the highest risk of stricture formation and ureteral obliteration, which was 64 times (p=0.0001) higher than in uncomplicated ureteroscopy., Conclusion: The rate of complications of ureterolithotripsy directly depends on the following factors: size and location of the stone, the stone impaction, pre- and intraoperative (nephrostomy tube) drainage of the upper urinary tract, the degree of hydronephrosis, level of bacteriuria and intraoperative trauma complications.

Stones located in the UPJ are accompanied by the most severe violation of the upper urinary tract urodynamics compared to other localizations of stones, which often leads to severe septic complications requiring emergency care. The study has evaluated the results of treatment of 147 patients with UPJ stones using various methods of treatment, and their efficacy in these patients. Extracorporeal shockwave lithotripsy (ESWL) was performed in 55 patients, contact ureterolithotripsy (CULT)--in 23 patients, percutaneous nephroureterolithotripsy and nephroureterolithoextraction (PCNLT and PCNLE)--in 43 patients, and open surgery (ureterolithotomy, pelviolithotomy)--in 26 patients. The best results in all parameters were obtained from patients with stone size up to 1 cm after ESWL, as well as in patients with stone size greater than 1 cm after PCNLT (PCNLE). In these groups, full discharge of stone at 3 months after treatment was achieved in 95 and 97.7% of patients, respectively. Complications in the ESWL group were recorded in 14.6% of patients, in the PCNLT (PCNLE) group--in 9.2% of patients.

The article presents the results of 42 retrograde nephrolithotripsy (RNLT) performed on 38 patients with staghorn nephrolithiasis. The staghorn cacculi SN-2 were most frequently indication for the intervention. 3 months after surgery, full exemption of the kidney from the fragments was observed in 85,6% of patients. RNLT is an effective and safe treatment for patients with staghorn stones with relatively low need for additional procedures. RNLT allows to reduce postoperative hospital stay and recovery period of patients.

A total of 323 transcutaneous roentgenoendoscopic operations were made in 212 patients from January 2000 to December 2009 including 96 operations in 81 presenile and senile patients (87 and 9 operations, respectively). Transcutaneous nephrolithotripsy (TCNT) eliminated concrement from the kidney for one session in 59 (72.8%) patients. It proved to be the most sparing treatment in serious clinical situations and provided maximally complete evacuation of the concrement from the kidney. A total complication rate was 14.8%. All the complications were cured with conservative pharmacotherapy. TCNT has the same indications as open surgery, is a method of choice in presenile and senile patients with large, stag-horn and recurrent concrements of the kidney, impacted pelvicoureteral concrements, in impaired renal urodynamics and high bacteriuria. TCNT can be used as a second-line treatment in failure of extracorporeal shock-wave lithotripsy or in combination with it (sandwich-therapy) for complete concrement elimination.

We studied efficacy of transcutaneous nephrolithotripsy (TNLT) in patients with urolithiasis and anomalous upper urinary tract. For two years we performed TNLT in 148 patients with complicated forms of urolithiasis and anomalous kidneys (age 18-86, 76 females and 72 males). The examination for urolithiasis has found different anomalies of the urinary tract in these patients: double pelvis and ureter (9 cases--6.1%), lumbar dystopy of the kideney (59 cases--39.9%), horseshoe kidney (12 cases--8.1%), solitary cyst of the kidney (43 cases--29.0%), parapelvic cysts (25 cases--16.9%). Extracorporeal shock-wave lithotripsy (ESWL) was conducted as first-line treatment in the other 139 patients with nephroliths under 1.5-2 cm in size who had the following anomalies of the urinary system: a solitary kidney (n=14), double pelvis and ureter (n=26), anomalous position of the kidney (n=46), anomalous shape of the kidney (n=20), simple and parapelvic cysts (n=33). A total of 154 TNLT were performed in 148 patients. Transcutaneous interventions were most frequent in the treatment of coral (31.3%) and pelvoureteral (14.6%) concrements, one-stage operation was made in 143 patients. Transcutaneous puncture nephrostomy as the first stage was made in 5 patients. The concrements were removed by one operative intervention in 132 (89.2%) out of 148 patients. Exacerbation of pyelonephritis as a postoperative complication was treated conservatively in 12.5% patients. Residual fragments were diagnosed in 16 patients. Of them, 11 patients had multiple and 5 patients had coral concrements. Residual fragments were removed in 14 patients either by renephroscopy or by ESWL. Treatment of 139 patients with concrements less than 1.5-3 cm in size consisted in 197 ESWL sessions. In combination of anomaly and urolithiasis the number of lithotripsy sessions per one patient was 1.8 +/- 0.2. The least number of ESWL sessions per one patient was conducted in patients with lumbar dystopy of the kidney (1.3 +/- 0.45), the greatest number in horseshoe kidney (3.8 +/- 0.8). Evacuation of the concrements after ESWL depended on the type of anomaly and concrement location. It was 61-69% in patients with anomaly of the shape and position of the kidney, in cystic anomalies is was 89-91%. Open surgery was indicated in 7 patients who needed plastic surgery of hydronephrosis (4) and obstructive megaureter (3). Thus, low-invasive operations provide high efficacy of urolith removal in patients with anomalies of the urinary tract and can replace traumatic open operations.

A total of 1100 sessions of extracorporeal shock wave lithotripsy (ESWL) were made in 720 patients with urolithiasis in the last decade with application of LGK-Compact lithotripter which generates shock waves electrodynamically and has no focusing lens. Such lithotriptor allows ESWL in patients with a high anesthesiological risk. Fitting the LGK-Compact lithotriptor with an endourological complex ENDO-MIT tooled for low-invasive interventions under X-ray control enabled treatment of 467 patients with urolithiasis aged 30-80 years. Most of the patients (66.04%) were at the productive age of 18-50 years. ESWL on the LGK-Compact lithotriptor was made in 182 patients (mean number of sessions was 2.1). Six and 12 month follow-up examinations registered complete elimination of the fragments in 169 patients. Thirty-four patients with concrements of the intramural ureter were exposed to 1 to 3 sessions. The fragments eliminated for 1-14 days after the session in 25 patients. Three patients developed stone path which evacuated spontaneously in two cases. For 3 years transcutaneous nephrolithotripsy was conducted in 214 patients. The concrements were removed during one operation in 156 (72.9%) patients, 58 (26.1%) patients had residual fragments. Reoperation was made in 34 patients 7-12 days after the first intervention. In the rest 24 cases (11.2%) residual fragments were removed by means of ESWL on LGK-Compact. Thus, ESWL is a leading technique in management of uncomplicated uroliths maximum 2 cm in size. When indications to ESWL are limited or this method is not effective, the role of roentgenoendoscopic interventions, such as transcutaneous nephrolithotripsy and transurethral contact ureterolithotripsy, takes on special significance. Such clinical innovation as endourological complex ENDO-MIT with lithotripter LGK-Compact made in Russia opens new perspectives of the treatment of urolithiasis and other urological diseases due to introduction of novel highly effective domestic technologies leading to a significant reduction in the number of postoperative complications and time of treatment, to 1.5-2 fold reduction in costs of equipment compared to foreign analogues.

The precipitation of N-cetylamine, N-cetylacetamide, hexan-1,2-diol, cetyl alcohol, and poly(butyl metacrylate) in acetone-water media in the presence of the lipase from Pseudomonas fluorescens was found to be accompanied by the coprecipitation of the enzyme. Within the lyophilized coprecipitates, the lipase exhibits a high catalytic activity and enantioselectivity in the reaction of (1RS)-phenylethanol acetylation with vinyl acetate in t-butyl methyl ether. In order of increasing lipase activity, the coprecipitates can be arranged in the series: cetyl alcohol, poly(butyl metacrylate), hexadecane-1,2-diol, N-cetylamine, and N-cetylacetamide, with the activity 2.5- to 19-fold exceeding the activity of the native enzyme. The immobilization of the lipase on solid supports, such as Celite 545 (physical sorption) and Eupergit C250L (covalent binding), in the presence of hexadecane-1,2-diol was found to increase the esterifying activity of the enzyme. The English version of the paper.

A simple method for determining the enzymic hydrolysis parameters of lipid-like substrates and trilaurin assembled in monolayers at the water-air interface was suggested. At a surface pressure of 10 mN/m, the initial rates of lipolysis were found to be proportional to the decrease in area of the substrate monolayer caused by the enzymic hydrolysis in a single-compartment Langmuir balance. The kinetic parameters for the hydrolysis of trilaurin and three 1,3-dilaurylpseudoglycerides acetylated in position 2 with an amino acid (phenylalanine, leucine, or valine) catalyzed with lipase from Pseudomonas fluorescens were determined. Unlike models of enzymic hydrolysis that neglect the thickness of the substrate monolayer, our method allows the determination of kinetic parameters in standard dimensions. The values of kcat for the synthetic pseudoglycerides were found to be significantly higher than that for trilaurin, while the values of Km(app) were close. This may be due to the presence of positively charged primary amino groups in the molecules of pseudoglycerides.

This review describes new polymer materials for biomedical applications developed in the Polymers for Biology Laboratory of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences. These include composite rigid sorbents for biochromatography, polymer dispersions for immunoassay, polymer hydrogels for immobilization of enzymes and cells, and polymer ultra thin films as biomembrane models and materials for biosensors. Some general and specific properties of these new materials and models as well as examples of their applications are discussed.

Results of treatment of 30 patients of 50 to 90 years of age having choledocholithiasis by the method of extracorporeal lithotripsy (EL) combined with endoscopic operations on the major duodenal papilla are described. The first stage in the treatment was endoscopic papillosphincterotomy. There were 41 sessions of EL (at an average 1,37 procedure for each patient). In 15 patients spontaneous excretion of the fragments from the common bile duct was noted. The endoscopic sanitation of the common bile duct with a removal of fragments with the Dormia basket was fulfilled in 13 patients after EL. The method of choledocholithotomy proved to be ineffective in 2 patients. Sanitation of the common bile duct was performed in all the patients before their discharge from the hospital. Thus the results obtained allow considering the extracorporeal biliary lithotripsy when combined with endoscopic papillosphincterotomy as an effective method for treatment of patients with choledocholithiasis which not only supplements traditional surgical procedures but also may be used as an alternative method of treatment especially for patients with high operative risk.

The effectiveness of the RP HPLC application for the step-by-step analysis of the recombinant insulin production was studied. Properties of a number of commercial and experimental columns in different chromatographic conditions were considered. A three-dimension optimization of selectivity and resolution versus pH and ion strength was carried out. A mechanism of the resolution and selectivity control is suggested.

It is shown that 210Po in the complex with a sorbent can be fixed in the organs, particularly in the proximal renal tubules. This, in the authors' opinion, can be the cause of various complications of the therapy with the adsorbents including the development of tumours.

Application of some variants of HPLC for the step-by-step analysis of recombinant human insulin production was studied. Chromatographic columns with commercial and specially developed supports for size-exclusion, ion-exchange and reverse phase HPLC were used. Effective combinations of the chromatographic techniques for analysis of products and intermediates at every technological step were found and used for production of insulin. The authenticity of insulin obtained in the Shemyakin Institute of Bio-organic Chemistry by the scheme described in the present paper was confirmed by means of some physical and chemical methods and biological activity analysis.

Materials are presented on six cases of fatal acute radiation disease consequent to relatively proportional beta- and gamma-irradiation after accident in the nuclear submarine. The comparison is performed of this material with the data published on the radiation sequelae of the Chernobyl nuclear catastrophe.

A brief review of the pathology of human radiation sickness is presented. The author recommends providing information to the practitioners, including pathologists, of new data concerning the manifestations of acute radiation sickness at various forms of radiation damage induced in the extreme situations.

Biopsy specimens of the bone were examined and then subjected to morphometry in 49 patients with terminal renal failure. 43 patients were on chronic hemodialysis and 6 had undergone renal transplantation. Histomorphometry permitted calculating the relative area of the bone girdles in the preparation (in %), the relative resorption area (in %), and the osteocyte count per mm2 bone girdle. It is concluded that if the area of the bone girdle in the preparation is less than 23.8%, the patient on hemodialysis may be diagnosed as having dialysis osteomalacia. The reduction of the relative reabsorption area in patients with dialysis osteomalacia is insignificant and can be used as an auxiliary sign in differential diagnosis of renal osteopathies in patients on dialysis.

Quantitative changes of structural correlations of transplanted allogenic human kidneys were examined in the histological slides by means of computer micromorphometry. The measurements were performed in 663 transplants selected randomly which had been in the recipient's body from several hours till 14.5 years. As a result of the study, parameters of glomeruli, tubules, blood vessels and connective tissue in the overall mass of donor kidneys were established starting from the time before transplantation and 6 months, 1-1.5, 2-3, 4-5, 7-14.5 years after transplantation. A progressive increase of sclerotic changes in the transplant is confirmed and the hypotheses about their genesis are proposed.

The force trajectories of isometric wrist flexor efforts and corresponding EMG activity of forearm muscles were studied in healthy subjects. A target effort of 50 N was developed after the sound signal: the target level and force trajectory were displayed on the TV indicator. Force trajectories under conditions of visual control, kinesthetic control (without a visual target) and with random alternation of these regimens were compared. Wrist flexor EMG latencies were approximately equal under visual and kinesthetic control and noticeably longer when these conditions were alternated randomly. Relative error of the target effort reproduction and duration of late components of force trajectories were higher in absence of the visual target. When visual and kinesthetic regimes were alternated randomly the delay between EMG onset and force trajectory initiation increased; its values correlated positively with the duration of the first force derivative increase. Formation of different strategies for force trajectory correction under different experimental conditions is discussed.

Deposition of amorphous calcium salts in muscle tissue is not only of pathogenic but also of compensatory adaptive character. This occurs in response to bone exclusion from the system of regulation of calcium homeostasis (aluminum or severe uremic intoxication). Apparently, amorphous depositions of calcium salts may buffer fluctuations in ion concentration. Their accumulation is a marker of the weakening of the cellular mechanisms and enhancement of the physicochemical ones by which calcium homeostasis is maintained.

The material of 560 allogenic corpse kidney transplantations was studied and the conclusion drawn on the possibility of the development in the kidney graft of two types of vascular lesions. The first type is referred to as a genuine angiopathy the causes and structure of which change depending on the time of donor kidney persistence in the recipient. The second type is regarded as immune vasculitis. The role of some immune and non-immune factors in the development of transplant vascular bed changes is discussed.

Transition processes of the length changes were studied in the ankle extensors of anesthetized cat. Indetermination was shown to exist in equilibrium length of this muscle. The value of equilibrium length depended on the direction of transition process. Equilibrium length invariably was higher in transition processes of shortening compared with that of lengthening. It has been shown that the observed indetermination of the equilibrium length is connected with hysteretical properties of the muscle contraction.

Artificial sorbents that comprise macroporous glass covered by the copolymer of N-vinylpyrrolidone and N-substituted acrylamide have been synthesized. Aminoethanol is bound to acrylic acid residue in one sorbent (AE-glass), whereas the other sorbent involves immunoglobulin G with the hexamethylenediamine spacer (IgG-glass). C1q binds specifically to IgG-glass with Ka 4,07(+/- 0,32) X 10(7) M-1. Free energy of the C1q binding to IgG-glass is twice higher than that of its binding to monomeric IgG. This evidences that one C1q molecule associates with two IgG molecules of the sorbent. A weak nonspecific sorption of C1q to AE-glass was found. Both specific (on IgG-glass) and nonspecific (on AE-glass) sorption of the first component of complement activate the classical pathway in human serum as manifested in the consumption of the C4, C2, C3 and C5 components. IgG-glass was employed for C1q isolation from human serum by affinity chromatography, whereas unbound part of serum may be used as a reagent R1q. The yield of highly purified C1q after IgG-glass affinity chromatography and gel filtration on Sephacryl S-300 is 63,6%.

Comparison of the results of morphological investigations of the internal organs of dogs and sheep with gamma-neutron radiation sources, implanted in the abdominal cavity, has shown that the correlation between a degree of severity and type of morphological changes in this case is similar to that of identical irradiation from an external source.

An affinity sorbent comprising macroporous glass coated with the polymer with the polymer with immobilized immunoglobulin IgG was used for the isolation from human serum of the first component of the complement and for its separation into subcomponents C1r, C1s and C1q by the one-step procedure. Serum C1 was quantitatively bound to the sorbent at 0 degrees C. The unbound part of the serum can be used as a R1 reagent for determining the hemolytic activity of C1. After activation of bound C1 by heating (30 degrees C, 40 min) the activated subcomponent C1r is eluted from the sorbent. Stepwise elution with EDTA at pH 7.4 or with EDTA + 1 M NaCl at pH 8.5 results in a selective and quantitative elution of the activated subcomponent C1s and subcomponent C1q. Stepwise elution of C1 subcomponents from the affinity sorbent after activation reflects the process of C1 breakdown following its activation on immune complexes.

In the diagnosis of osteomalacia in patients with terminal renal insufficiency after the method of dynamic scintigraphy with diphosphonate major emphasis should be placed on the coefficient of RP blood elimination (C1). The disease should be diagnosed in C1 below 0.1 min.-1. A relative increase in the coefficient of cumulative RP in the bones (C2) as compared to C1 (greater than 2-fold) should be regarded an accessory sign in the diagnosis of osteomalacia.

The methods of the modification of Salmonella O- and H-antigens and the preparation of biologically active sorbents on their basis have been developed. The use of these sorbents has permitted the isolation of affinity antibodies with strictly defined specific activity. The work shows the possibility of the successful use of carriers obtained on the basis of porous glass, chemically modified by acrylic copolymers containing activated carboxylic groups, and intended for the immobilization of antigens of both protein and carbohydrate nature.

Macro- and microtopography of the distribution of aspirated colloidal 144CeF3 in autographs of rabbit lung total sections were examined with the help of a monitoring-measuring device "Videoplan" and microcomputer. Quantitative assessment of photoemulsion-blackening areas at the site of radionuclide concentration has confirmed that aspirated radionuclides are distributed in the lungs according to the same laws as nonradioactive aerosols: the relation of total microvolumes of actually irradiated pulmonary tissue to the entire lung volume long after radionuclide entry is shown; a possibility to use these data for determination of an actually absorbed dose in microvolumes of pulmonary tissue during aspiration of radionuclides is considered.

The dependence of the rate of spontaneous hydrolysis of tryptophan ethyl ester within a wide range of pH (4,6-10,3) was studied. This dependence was found to differ from other dependences, i.e. within the pH range of 4,6-7,0 the value of the rate constant is practically independent on pH. In order to describe the dependence obtained a general pattern of hydrolysis was postulated and the kinetic parameters of individual elementary reactions were determined. The rate constants for the hydrolysis of the amino acid with a non-protonated amino group of ester was calculated using the literary values for the rate constants of carboxylic acid hydrolysis. The obtained values of the second order rate constants for the alkaline hydrolysis of non-protonated and protonated forms of tryptophane ester (k4 and k5) are 1,1 and 79 M-1 s-1, respectively; those for the hydrolysis of the protonated form of the substrate (k3) are 1,0.10(-5) M-1 s-1. The role of spontaneous (non-enzymatic) hydrolysis in stereoselective cleavage of amino acid esters is discussed.

A study was made of morphological changes in the testes of 120 rats fed for 20 months only food exposed to gamma-rays. Pronounced alterative-dystrophic disorders up to foci of coagulation necrosis and aspermatogenesis as well as compensatory-adaptation processes such as proliferation of Leydig cells were found. A direct correlation was disclosed between the severity of structural alterations in the testes and the dose of gamma-rays to which the products used for animals' feeding had been exposed. A suggestion is made about the autoimmune mechanism of structural alterations discovered.

Morphological changes were studied in the kidneys of albino rats and their progeny fed only with irradiated food for 20 months. Morphological signs of the autoimmune process in the form of the membraneous-proliferative glomerulonephritis in combination with characteristic disturbances of the blood vessels and extensive lymphoid-histiocyticeosinophilis infiltration of the stroma were revealed.

N-vinylpyrrolidone-N(2-hydroxy) acrylamide copolymer-modified porous glass was studied as a support for gel permeation chromatography. Influenza, Sendai, fowl plague viruses and rota-viruses were purified by chromatography on the support. As compared with Sepharose 4B the support shows better hydrodynamic properties and yields higher amounts of purified viruses. The support can be also applied to the t-RNA and ribosomes separation.

The structure of allotransplanted kidneys (AK) from human cadavers that remained in the recipient's body for a long time (4 months-6 years) has been studied. AK that preserved good function up to the patient's death not consequent on the transplant insufficiency showed a weak immunocellular connective tissue, with the epithelium of proximal canaliculi being cytologically reconstructed. The reconstruction lay in formation of numerous polykaryocytes having a hypertrophied brush-like outline. This phenomenon ("proximal polykaryocytosis") is assessed as a manifestation of regeneratory potencies of the epithelium of AK proximal tubules in late periods after transplantation. Chronic moderate hypoxia of AK was conducive to reconstruction of the epithelium of the nephron proximal part. Inadequate function of AK was related to the development of chronic rejection resistant to the treatment, and AK demonstrated an intensive immunocellular reaction and developed gross sclerosis that produced atrophy of most AK tubular.

The analysis of 550 records of autopsies of patients who had suffered from chronic renal insufficiency and had been treated by transplantation of corpse kidney, programme hemodialysis, and conservatively, was carried out. Significant differences in the structure of complications and causes of death in these kinds of correction of the terminal stage of chronic renal insufficiency were established. Each of them has its own most frequent causes of complications and fatal outcomes associated both with the main disease and the type of treatment used.

On the basis of morphological data it was established that spontaneous ruptures of allotransplanted kidneys of man were connected mainly with juxtamedullar shunting of their blood flow; Impairment of the blood flow was apparently caused both by immune and nonimmune endogenous humoral factors. The pathomorphological picture in spontaneous ruptures of transplants differed from structural changes observed in traumatic damage of the kidney.