Method for ureteral lithotomy

FIELD: medicine, urology.

SUBSTANCE: one should affect ureteral area through ureteral projections with flicker-sound magnetic field, its spectral constituents being in the range of the following frequencies 2.5·10-4 - 2.5·101 Hz, and maximal amplitude of magnetic induction - within 0.1-0.5 mcTl. Duration of the procedure corresponds to about 30-60 min. The quantity of procedures - 1-3 daily. At detecting renal stones the diameter being above internal ureteral one should fulfill lithotrypsy before the impact with magnetic field. About 1-2 h before the impact with magnetic field it is necessary to introduce spasmolytic medicinal preparation. In the course of about 30-60 min before the impact with magnetic field and during this impact it is necessary to heat patient's body surface in area of ureteral projection. The innovation enables to shorten the duration of therapy.

EFFECT: higher efficiency.

3 cl, 3 ex

 

The invention relates to urology and can be used for removing small stones (up to 8 mm in diameter) of the ureter, as well as to improve the functioning of the kidneys and urinary tract, including in the postoperative period.

Stone (calculus) in the ureter, as obtenerse factor, dangerous dangerous complications (acute purulent pyelonephritis, infected hydronephrosis, bakteriostaticheski shock, which requires emergency surgical intervention. Manifestation of acute pathological condition in renal stone disease is often renal colic, which is based on the obstruction of the lumen of the ureter at any level, contribute to a violation of the outflow of urine from the kidneys, acute disruption of blood circulation in it and then hardened spasm of the ureter, pelvis and calyx. Intense pain in this case continue from several hours to several days. In the absence of positive dynamics within 10-12 days complications, life-threatening patient due to reflex anuria. Against this background, the progress of deterioration of the functions of the gastrointestinal tract, liver, pancreas, develops acute heart failure.

One of the most effective tactics to prevent these complications is to ensure the timely restoration of the passage of MOC is. To do this, the efforts of the physician are directed to clear, in the short term, the diagnosis, which, primarily, are x-ray and ultrasound (sometimes tomography) examination of the kidney and ureter prior to the beginning of treatment.

Known surgical method for the removal of stones from the ureter during abdominal surgery [1. Tiktinsky WAS Urolithiasis. - L.: Medicine, 1980. - Pp.92-148]. Disadvantages it is the destruction of tissue structures, including the structure of the ureters, the complexity and high cost of surgery, a long recovery period.

The known method of removal (extraction) of stones from the ureter using a puller (ureterolithotomy) with x-ray or endoscopic control system [2. Kogan M.I., Sknr V.A. Pavlov, S.V. Ureterolithotomy - its place in the modern treatment of ureteral stones. //Abstracts of papers.: The Plenum of the all-Russian scientific society of urologists, Rostov-on-don, September 24-25, 1992. - P80-81]. The disadvantages of it are tissue damage, possible postoperative complications, prolonged rehabilitation period.

In those cases when it is impossible to pass the extractor above the stone for its capture, use extracorporeal shock wave lithotripsy or contact endoscopic ureterolithotripsy (using pulse and rustichesky waves or electrohydraulic shock) [1]. The disadvantages of lithotripsy are a long rehabilitation period and high cost of treatment.

The known method of removing stones from the urinary tract by acting on the kidneys and ureters sinusoidal modulated currents (SMC-therapy) [3. Clinical physiotherapy: a reference guide for the practitioner. Edited Innocene /Innocen, Ldendy, Evergeen and other Kyiv: Health, 1996. - S-225]. To do this, one electrode sizes 6·4 cm2have in the area of the projection of the kidneys and ureters, and the other electrode sizes 8·6 cm2- in the upper abdomen. The electrodes using insulated wires connected to the generator output sine-modulated voltage. The frequency of the sinusoidal oscillations set in the range of 20-30 Hz. Modulation of sinusoidal oscillations provide a square wave with a period of 10 seconds, the modulation Depth is 100%. Current set of this magnitude, which appear contraction of the muscles of the abdominal wall or pressing sensation in the course of the ureter. Typically, current is 10-30 mA. The duration of the procedure chosen within 6-8 minutes Treatments are applied daily or every other day. Course of treatment - up to 15 procedures. CMT-therapy applied after 15-20 min after inductothermy or microwave therapy and intake of 400-600 ml of fluid.

The disadvantages of this pic is BA are the low efficiency of treatment and the limitations of its application (due to contra-indications when the number of diseases). In the process of how powerful tutu AC proceed mainly in tissues with the highest electrical conductivity, but not on a trajectory passing through the kidneys and ureters. They disrupt the normal operation of the systems, which are transmitted endogenous information signals that sometimes disrupts the urinary tract and leads to the peristaltic reflex effect. Spasmodic contraction of the surrounding stones tissues lead to their injury. This method of stone removal is contraindicated in heart failure, the presence of a pacemaker, tumors and other diseases.

Closest to the claimed method is a method of removing stones from the urinary tract, including the impact on the region of the ureter through their projections sine-modulated magnetic field [4. RF patent №2070074, IPC 6 And 61 N 2/04, publ. 10.12.1996,]. The frequency of the sinusoidal oscillation is chosen in the range of 2-3 kHz.

Modulation of sinusoidal oscillations provide a square wave with a frequency of 5-6 Hz. The modulation depth is 100%. The value of magnetic induction in the areas of ureter choose within 1-5 MT. Within five days of daily conduct two sessions of each treatment for 8 min with a break between sessions of 60 minutes Then 10 day five-day repeat cycle who is actvie on the kidneys and ureters.

The disadvantages of the prototype method are the low efficiency of treatment due to non-optimal spectral composition affecting the human body's magnetic field and a high value of magnetic induction (1-5 MT), the duration of treatment (up to 20 days), the number of contraindications.

Spectral composition affecting the human body magnetic field in the method-prototype contains the carrier frequency being in the range of 2-3 kHz and lateral components from the odd harmonics of the square wave. When the detection of amplitude-modulated oscillations biological membranes (which are nonlinear elements at low and ultra low frequencies) through them currents of odd harmonics of the square wave. The high level of the first harmonic of the square wave (5-6 Hz) negatively affects the nervous and cardiovascular system (especially dangerous to human health of electromagnetic and acoustic oscillations with a frequency of 7 Hz). Contraindications to the use of the prototype method are cardiovascular disease, the presence of a pacemaker, low adaptive capacity of the patient, meteochuvstvenosti.

Objectives, seeks to achieve the proposed solution is to increase efficiency of treatment (including in the case where the removal of stones from the ureter precedes lithotripsy what I kidney stones), reducing the duration of treatment, elimination of side effects and contraindications to the use of the method.

This is achieved by a method of removing stones from the urinary tract includes the same as prototype method, the influence of an alternating magnetic field in the region of the ureter through their projections.

According to the invention, as an alternating magnetic field using the flicker-noise magnetic field, the spectral components which are in the frequency range 2.5·10-4-2.5·101Hz. The maximum amplitude of the magnetic induction in the areas of the ureter is chosen in the range from 0.1 to 0.5 MT, the exposure duration of the flicker noise of the magnetic field during one procedure from 30 to 60 min, the number of procedures per day from 1 to 3, and the duration of treatment is from 1 to 3 days.

Upon detection of kidney stones with a diameter exceeding the inner diameter of the ureter during their normal operation, before the impact on the region of the ureter flicker-noise magnetic field are lithotripsy of kidney stones.

In private cases for 1-2 hours prior to the impact of flicker noise magnetic field, the patient is given an antispasmodic drug and/or within 30-60 minutes prior to the impact of flicker noise magnanim field and in the process impact assests the Ute heating the body of the patient in the areas of projections of the urinary tract (for example, using a heating pad).

The proposed method for the removal of stones from the kidneys and ureters are based on the normalization processes in cells and tissues of the body under the influence of weak low-frequency (VLF) flicker noise (FSH) magnetic field (MT) on the background of constant MP of the Earth. The spectral density of FS oscillations is inversely proportional to the frequency. FS MP together with the constant part MP of the Earth serves as an information role for ionic, molecular and cellular levels and synchronizes (normalizes) the processes in the cells. A significant role in these processes perform biological membranes, which is the link between the objects of animate and inanimate nature. First, they are highly sensitive nonlinear VLF receiving elements of electromagnetic and acoustic waves whose sensitivity to these oscillations is of the order of 10-16W/cm2[5. Pasko O.A., Semenov A.V. ABOUT the role of electric double layers in the interaction of objects of animate and inanimate nature. Proc. Dokl. Fourth Pushchino Symposium: "Correlation of biological and physico-chemical processes in space and Heliophysical factors", Pushchino, 1996. - P.143-144], and, secondly, generators VLF electromagnetic and acoustic FSH fluctuations. Impact FSH magnetic and/or acoustic oscillations in the membrane results in the increase of their permeability and normalization of metabolic processes in cells. Acting VLF fluctuations on the kidneys and ureters in the present method adequate electromagnetic FSH fluctuations in the membranes of healthy human cells.

Effects from exposure to FSH MP unusual in its properties. They are small, slowly developing. Their latent (hidden) periods long and vary from several minutes to several hours.

The proposed method has its own spasmolytic properties and without the use of antispasmodic drugs, and thermal effects on the kidneys and ureters. When the effects on the kidneys and the ureters, containing stones, FS MP is relieving spasms of smooth muscles of the urinary tract. The inner diameters of the ureters dilate up to 8-10 mm, appears normal peristalsis of smooth muscle of the kidney and ureter, and stones (diameter up to 8 mm, and sometimes up to 10 mm) descend into the bladder.

Lower frequency limit of the claimed range of FS oscillations fn=2.5·10-4Hz corresponds to a maximum duration of one procedure Tmax=60 min (fn=1/Tmax). To increase the time of one procedure over 60 min, in our opinion, it is impractical, although VLF FSH fluctuations in the membranes of cells are observed at frequencies below 2.5·10-4Hz. To increase the upper cutoff frequency above 25 Hz is also impractical, since the frequency is parametricheskikh resonances for the first the second and third harmonics of the oscillations of the most important biological ions (inorganic cations and anions, organic acids, coenzymes, DNA, lipids, neurotransmitters, proteins) are below this frequency [6. Uzda A.B. ON biological effects of elf magnetic fields: resonant mechanisms and their implementation in cells //Biophysics. - 2000. - V.45. - Vol.5. - S-893].

The positive effect from the use of the inventive method is achieved and the impact on the region of the ureter FS MP with a maximum amplitude of the induction less than 0.1 MT (in the case of low magnetic interference networks of industrial frequency and devices powered by these networks) and more than 0.5 MT. However, in the latter case, this leads to an increase of the dimensions of the devices used in the implementation of this method, and/or increased consumption of power sources of power.

Duration of less than 30 min impractical due to the elimination in the spectrum of FS fluctuations of several significant for biological membranes frequencies. Procedures lasting more than one hour irritate the patient.

Studies on the removal of stones from the ureter in 13 patients, conducted in medical unit-2 Tomsk in 2004, showed that the duration of the treatment of FS MP did not exceed 3 days.

Additional use of antispasmodic drugs and naked what s the body surface of the patient in the areas of projections of the ureters speeds up the process down stones.

Below are examples of the removal of stones from the ureter of the proposed method. For this purpose, we used a device that contains connected in series interface, microcontroller, programmable memory device, digital to analog Converter, the current amplifier and the inductive coil [7. RF patent №2243007, IPC 7 And 61 N 2/00, 1/00, 5/06, And 61 G 7/04, publ. 27.12.2004,]. The coil was made in the form of a round loop, containing seven turns of insulated wire. The inner diameter of the coil was 100 mm In the reprogrammable memory storage device was recorded FSH signal, the spectral components which stretched from 2.5·10-4up to 25 Hz. Maximum amplitude of FS magnetic induction at the location of the ureters was 0.3 MT. Loop superimposed on razdetoy or clothed body of the patient in the area of projection of the ureter, containing the stone. FS MP from this loop was affected also by the kidney, which left the ureter. Stone removal was conducted in medical unit-2 Tomsk in 2005

Example 1. Patient S., 62 years of age, was treated in the urology Department of MSU-2 with complaints paroxysmal pain in the lumbar region on the right, with radiating pain in the right iliac region, periodic feeling chills, nausea, vomiting. These phenomena have been observed in the last three the ducks for the first time. On palpation, there was a strong soreness in the course of the right ureter. There was a strongly positive symptom of Pasternack. In urine was observed in isolated leukocytes and fresh erythrocytes and 12-15 in the field of view. According to the survey radiography of the urinary tract were observed contrasting shade sizes 4×5 mm2along the lower third of the right ureter. The results of the ultrasound examination of the kidneys were typical for violations of the outflow of urine from the abdominal system of the right kidney, which was subsequently confirmed by the data of excretory urography.

On the basis of the anamnesis, the patient's condition during his inspection and has been diagnosed with a stone in the lower third of the right ureter (marked right-sided renal colic).

Due to ineffectiveness during the two days of symptomatic therapy, during which the patient intramuscularly and intravenously was administered baralgin, on the third day he was appointed therapy FSH MP lower third of the right ureter three times a day 30 minutes after 6 hours. After the third session the next urination moved the stone with a diameter of 5 mm Paroxysmal pain stopped. Subsequently normalized urine tests, ultrasound data and survey radiography of the urinary tract.

Example 2. Patient S., aged 29, was treated in the urology Department of MSU-2 type is offered by the pattern of renal colic right the first time. The attacks of pain were accompanied by characteristic changes in the urine, in which the number of fresh erythrocytes in the field of view was 30-35. Ultrasound detected ectasia pelvis-checkoway system of the right kidney and the upper third of the ureter. Observed severe pain at the level of localization of the right kidney and sharply positive symptom of Pasternack. Before applying to the urology Department, the patient was taken broths diuretic herbs, baralgin (3 times daily), urolesan (10 drops 3 times a day), thermal treatments. In the urology Department was assigned therapy FSH MP (three times a day 30 minutes after 6 hours. Less than a day, the patient appeared typical signs of shifting stone to nagpupursige Department of the ureter, i.e. symptoms of pollakiuria - peremptory increased urination. On the third day of pain in the lumbar region ceased, urine normal. According to the survey radiography of the urinary tract stone in the ureter was not. Observations after the end of treatment was absent.

Example 3. Patient K., 52 years old, was admitted to the hospital urology Department MSCH-2 in an emergency with paroxysmal pain in the left lumbar region, with radiating pain in the left groin area, the increase of the urination, recurrent pain at the end of act mo is eemission, chills, nausea. The patient differed restless behavior (defined body position to improve the condition not found). Had a pained look, the palm of the left hand was supporting the lumbar area to the left. Palpation was observed severe pain in the left hypochondrium and groin area on the left. In urine was observed in isolated leukocytes and 10-12 fresh erythrocytes in the field of view, a salt of oxalate. There was a strongly positive symptom of Pasternack. Data survey radiography of the urinary tract confirmed the presence of stone with a diameter of 4 mm along the lower third of the left ureter. According to the results of the ultrasound examination of the kidneys was observed clear signs of expansion of the cavity system of the left kidney, which is characteristic for violations of the outflow of urine through the ureter. This situation was confirmed by excretory urography.

In the absence of positive dynamics for two days, during which time carried out pharmacological therapy and used water load and the subsequent sharp jumps of the patient on the left leg, the patient was assigned therapy FSH MP along the lower third of the left ureter (three times a day 30 minutes after 6 hours. Less than a day marked the passage of stone with a diameter of 4 mm General condition of the patient after discharge of the stone was quite satisfactory. The control ultrasound of the kidneys showed that exp is by ectasia of the cups and the pelvis of the left kidney there. Discharged from the hospital with the recommendation: outpatient supervision of a urologist at the place of residence.

The above examples convincingly demonstrate the effectiveness of the removal of stones from the ureter offer a non-invasive way. If to remove the stones from the ureter method of the prototype requires up to 20 days, the proposed method is up to 3 days. To remove the stones from the ureter by the claimed method sufficient maximum amplitude of induction MP, 1000 times smaller than in the method prototype. The inventive method has no contraindications to the use of the low induction values MP, affecting the rights, which is below the values of magnetic induction subwoofer interference networks of industrial frequency and electrical appliances, and normalizing the character of the spectrum of FS MP.

This method can be used both independently and in treatment of renal stone disease. The advantage of this method is its cheapness.

1. Way of the removal of stones from the urinary tract, including the impact on the area of the ureter through their projections alternating magnetic field, characterized in that an alternating magnetic field using the flicker-noise magnetic field, the spectral components which are in the frequency range of 2.5·10-4-2,5·101G is, the maximum amplitude of the magnetic induction in the areas of the ureter is chosen in the range from 0.1 to 0.5 MT, the exposure duration of the flicker noise of the magnetic field during one procedure from 30 to 60 min, the number of procedures per day from 1 to 3, and the duration of treatment is from 1 to 3 days.

2. The method according to claim 1, characterized in that the detection of kidney stones, a diameter which exceeds the inner diameter of the ureter during their normal operation, before the impact on the area of the ureter flicker-noise magnetic field are lithotripsy of kidney stones.

3. The method according to claim 1 or 2, characterized in that for 1-2 h before exposure flicker-noise magnetic field, the patient is given an antispasmodic drug.

4. The method according to claim 1 or 2, characterized in that within 30-60 min before exposure flicker-noise magnetic field and in the process influence exercised by heating the body surface of the patient in the areas of projections of the ureter.



 

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14 cl, 33 tbl, 561 ex

FIELD: organic chemistry, medicine, pharmacy.

SUBSTANCE: invention proposes derivative of 3,4-dihydroisoquinoline of the formula (I) or its nontoxic salt and a pharmaceutical agent comprising its as an active component (wherein all symbols have the same values as given in description). Compound of the formula (I) possesses agonistic effect on CB2-receptors and, therefore, it can be used for prophylaxis and/or treatment of different diseases, for example, asthma, nasal allergy, atopic dermatitis, autoimmune diseases, rheumatic arthritis, immune dysfunction, postoperative pain and carcinomatous pain.

EFFECT: valuable medicinal properties of derivatives.

14 cl, 33 tbl, 561 ex

FIELD: organic chemistry, medicine, pharmacy.

SUBSTANCE: claim describes substituted anthranylamides of the general formula (I): wherein A means group =NR7; W means oxygen atom; D, E, F, G, X, Z, R1, R2, R7 and R9 have values given in the description and their isomers and salts also. Also, claim describes intermediate compounds used in preparing indicated anthranylamides. Also, invention relates to medicinal agents, their compositions and their using. Proposed compounds can be used in treatment of diseases associated with persistent angiogenesis that can be cause of different diseases, such as psoriasis, arthritis, for example, rheumatic arthritis, hemangioma, angiofibroma, ophthalmic diseases, for example, diabetic retinopathy, neovascular glaucoma, kidney diseases, for example, glomerulonephritis, diabetic nephropathy, malignant nephrosclerosis, thrombosis microangiopathy, rejection of transplants and glomerulopathy, fibrosis diseases, for example, hepatic cirrhosis, diseases associated with proliferation of mesangial cells and arteriosclerosis that can result to progression of these diseases. Invention provides the development of the corresponding medicinal agent designated for treatment of abovementioned diseases. The development of the preparation allows expanding assortment of agents used in treatment of such diseases.

EFFECT: valuable medicinal properties of compounds.

FIELD: organic chemistry, chemical technology, biochemistry.

SUBSTANCE: invention relates to new substituted 6-sulfo-2-oxo-1,2-dihydroquinoline 4-carboxylic acids and their derivatives of the general formula (1):

eliciting physiological activity, in particular, capacity to inhibit activity of protein kinase, and also to intermediate compounds for their preparing and to the focused library, for search compound-leaders and medicinal candidates obtaining on the basis of screening combinatory libraries. In compounds of the general formula (1) R1 represents hydrogen atom or electrophilic substitute; R2 represents hydrogen atom or inert substitute; R3 represents optionally substituted hydroxyl group, optionally substituted amino-group and optionally substituted azaheterocycle; R4 represents optionally substituted amino-group and optionally substituted azaheterocycle. Also, invention relates to compounds of the general formula (1.1):

wherein R1, R2 and R3 have above given values; R5 represents hydroxyl or chlorine atom, and to their applying for preparing compounds of the general formula (1.2):

and (1.3):

wherein R1, R2 and R4 have above given values.

EFFECT: valuable medicinal and biochemical properties of compounds.

6 cl, 4 tbl, 5 ex

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