Method for endoscopic correction of cystoureteric reflux

FIELD: medicine, urology.

SUBSTANCE: it is necessary to introduce autofibronectin under ureteric mucosa at the distance of about 4-5 mm being below its foramen in avascular area, at 5-6-7 endoscopic hours at the dosage of 5-10 ml till complete closing the mouth at the top of the tubercle developed. The innovation provides efficient removal of cystoureteric reflux, accelerates activation of fibroblasts and mobilization of collagen in area of fibronectin injection and prevents the manifestation of local inflammatory and general allergic reactions.

EFFECT: higher efficiency.

2 ex

 

The invention relates to medicine, namely urology.

To protect the kidneys in vesicoureteral-reflux, there are various ways antireflux plasty. Endoscopic correction proposed in 1981 E.Matoushek, is an alternative to surgical treatment of vesicoureteral reflux.

The method consists in the restoration of antireflux function of the ureter by introducing under his output Department inert liquid ("indifferent" to the human tissue) of the polymer. The polymer forms a tubercle, which, after solidification serves as a rigid support for the ureter, the top wall which covers tightly to the bottom, provides antireflux valve function.

As the locking substances placed under the mouth of the ureter, Nemenova A.A., Chepurov A.K. 1993, Kumar R., Puri P. 1998, apply Teflon paste, D. Herz, A. Hafez 2001 silicone, Lackgren g, Wahlin n, Stenberg A. 1999 - hyaluronic acid, Soloviev A. - gel Interfall, Ostrovsky, NV, Debt BV - gel "Formacel".

The study of long-term results showed that Teflon is dangerous to use, as it is a known carcinogen. There is a risk of vascular migration of the drug in vital organs: brain, liver, lungs. In addition, a possible stenosis of the ureter at its introduction. The silicone so the e is a synthetic material, has the same drawbacks as Teflon, and therefore its application in practice should also be limited.

The most widely as a fixing substance in the endoscopic treatment of vesicoureteral reflux apply collagen Babanin I.L., Kazan IV, Konoplev E, 2002. A.Haferkamp et al. use bovine collagen concentration of 35 mg/ml 1.5-1.6 ml of solution, which is introduced subureteral. Due to the frequent recurrence of reflux collagen is necessary to introduce two - and three-fold. Because the substance is of animal origin may develop immune reactions to its implementation.

When endoscopic treatment of vesicoureteral reflux using autologous substances: chondrocytes, muscle cells. ..Caldamone, D.A.Diamond applied endoscopic transureteral introduction autologous chondrocytes in a trigonal area for 29 children with vesicoureteral reflux II-I degree with good effect.

The prototype of the invention is a method Nbelieve, Lagarith, Art, Musawwarat, Djaelani transurethral injection of culture of the auto - or alloparental person with the purpose of correction of vesicoureteral reflux (patent No. 2230501, 2004). The source material for culturing fibroblasts obtained from biopsy own skin of a patient for 3-4 weeks. before the operation. Sampling size is rum 5-10 mm is taken from the skin of the forearm or behind the field after anesthesia with 0.5% solution of novocaine into the vial with the environment "Needle" with the antibiotic and intimidation. Source of allogeneic fibroblasts is healthy skin obtained after "circumcisio". The skin is removed during the operation, is placed into the vial with the environment "Needle" and delivered to the laboratory. The blood of the patient before surgery examined for HbsAg, HIV, RW.

Cell culture obtained by conventional method. For transplantation, the use of culture passages 4-10, sterile, decontaminable mycoplasmas and viruses. Sterility is controlled daily microscopically, contamination - using polymerase chain reaction in the laboratory Nizhny Novgorod research Institute of epidemiology and Microbiology prior to transplantation of culture.

For transplantation apply crops of good quality, formed a confluent monolayer, the cells must be clearly defined, with dense nuclei, expressed appendices. On the day of surgery, the cells are removed from the surface of the culture vessel using trypsinization, washed twice with sterile physiological solution of sodium chloride, the concentration of cells is brought up to 3.5-7 million/ml, they are placed in a sterile tube and sterile Bix delivered to the operating room. Auto - and alleyball person get in laboratory tissue preservation research laboratory Department of the Nizhny Novgorod research Institute of traumatology and orthopedics health Ministry.

To perform the OPE is then used cystoscopy company "Karl Shtorz" age appropriate diameters. Endoscopy is performed under intravenous anesthesia with kalipsola. Using a special injection needle carried out through the working channel of the cystoscope, auto - and alleyball person in the amount of 3.5 to 7 million cells contained 1.5-2.0 ml of saline solution, injected under the mucosa of ureter at a distance of 4-5 mm below the holes in the avascular zone, 5-6-7-m endoscopic hours, until complete closure of the mouth on the top of the formed submucosal tubercle. Drainage of the bladder urethral catheter Foley is carried out within 24 hours ultrasound of the kidneys and bladder is held for 1-2 days after manipulation. Discharged patients for 2-3 days. Control cystography is performed after 6 months.

However, with this method there are significant technical difficulties at the stage of preparation of culture autofollow.

The technical result is to facilitate the method, therapeutic effect is achieved in the near term due to the mechanical closing of the vesicoureteral junction, in the distant due to the activation of fibroblasts and substitution introduced fibronectin own collagen, as well as, we assume, acceleration of ripening own antireflux mechanisms. Additionally, the use of own autofinancing patient prevents local inflammatory and shared allergicheskie reaction.

The proposed method is as follows.

To prepare autofinancing produce blood from a peripheral vein of the patient in a double bag for blood collection "Teruflex" or "gamecon with stabilizer at put od srda street-1. Next blood fragmenting in the centrifuge RS-6 for 20 min at a speed of 1800 revolutions per minute Plasma using plasmacytoma press in a free bag, add heparin per 1 thousand UNITS per 100 ml eksponirovannoi plasma. RBC mass is returned to the patient. A bag of plasma placed in a refrigerator for 12 hours at a temperature of 4°With (for heprincipalreci FSA). After 12 hours the bag with plasma again placed in a centrifuge for 15 minutes at a speed of 3000 revolutions per min. Supernatant using plasmacytoma removed. The remaining concentrate FSA plasma is ready to use (can be frozen at a temperature of 20-40°With, to use during the week).

To perform the operation using cystoscopy company "R.Wolf" age appropriate diameters. Endoscopy is performed under intravenous anesthesia with kalipsola. Using a special injection needle carried out through the working channel of the cystoscope, autodirection in the volume of 5-10 ml is injected under the mucosa of ureter at a distance of 4-5 mm below the holes in the avascular zone, 5-6-7-m endoscopic hours, until the floor is th closing the mouth at the top of the formed submucosal tubercle. Ultrasound of the kidneys and bladder spend 1-2 days after manipulation. Discharged patients for 2-3 days. Control cystography is performed in 6-9 months.

As a result of this interference stops the reverse flow of urine, is the stimulation of local fibroblasts.

The method is illustrated by the following examples.

Example 1. Patient X., 12 years old, was admitted in the urology Department of our hospital RB with complaints of abdominal pain. Sick from an early age. History repeated exacerbation of pyelonephritis (more than 3 times per year).

Surveyed in the urology Department: clinical lab tests, functional tests (sample Rehberg, zimnitsky tests), ultrasound of the retroperitoneum, excretory urography, voiding cystography. Identified vesicoureteral reflux 2 degrees. Carried out the correction of reflux according to the described method. The child was discharged on the 3rd day after surgery. Checks on a quarterly basis include urine tests, ultrasound. At follow-exacerbation of pyelonephritis was not. A monitoring study conducted by voiding cystography, one year after intervention data for vesicoureteral reflux no.

Example 2.

Patient M 10 years old, was admitted in the urology Department of our hospital RB with complaints of abdominal pain. In the analysis of the x urine revealed leukocyturia, proteinuria. Sick from an early age. In 2003 conducted ureterocutaneostomy on both sides Cohen. After repeated acute pyelonephritis (more than 2 times per year). Surveyed in the urology Department: clinical lab tests, functional tests (sample Rehberg, zimnitsky tests), ultrasound of the retroperitoneum, excretory urography, voiding cystography. Identified left vesicoureteral reflux 1-2 degrees. After the relief of inflammation, the correction of reflux according to the described method. The child was discharged on the 5th day after the intervention. Checks on a quarterly basis include urine tests, ultrasound. At follow-exacerbation of pyelonephritis was not. A monitoring study conducted by voiding cystography, one year after intervention data for vesicoureteral reflux no.

According to this method produced 16 operations, in all cases the positive effect, the post-operative period tracked for 1 year, all patients re-produced: ultrasound examination of abdominal cavity organs, voiding cystography, excretory urography, data for recurrence of the disease was not detected. Surgery is technically simple to perform, does not require a long anesthesiologic the ski manuals and effectively eliminates vesicoureteral reflux.

A method of endoscopic correction of vesicoureteral reflux, including the introduction under the mucous membrane of the urethra at a distance of 4-5 mm below the holes in the avascular zone, 5-6-7 endoscopic hours autograft until complete closure of the mouth at the top of the formed bump, characterized in that the graft is injected autodirection at a dose of 5-10 ml



 

Same patents:

FIELD: medicine, pharmacy.

SUBSTANCE: invention describes compositions and methods for administration of oxybutynin in minimization of cases number and/or severity of negative effects of drugs associated with oxybutynin therapy. Invention proposes oxybutynin isomers and its metabolites that satisfy these indices in minimization of cases number and/or severity of negative effects of drugs and maintenance of useful and effective therapy in treatment of bladder diseases and showing enhanced activity. In some aspects proposed compositions can be represented as nonabsorbed or free formulation of gel designated for topical administration. Compositions and methods provide lower plasma blood concentrations of oxybutynin metabolites, such as N-desethyloxybutynin that as suggested contributes to at least partially to negative effect of drug and under maintaining the sufficient concentration of plasma blood oxybutynin in aims to provide usefulness to a patient treated with oxybutynin therapy.

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20 cl, 15 tbl, 7 dwg, 16 ex

FIELD: pharmaceutics.

SUBSTANCE: the present innovation deals with applying the derivatives of aryl- (or heteroaryl)azolyl carbinols of general formula , in which Ar is a phenyl radical or thienyl radical, substitutes, if necessary, R1 is a hydrogen atom or the lowest alkyl group, R2 is dialkylaminoalkyl or azaheterocyclyl alkyl and Het is azole, unsubstituted or substituted, if necessary, with one or two substitutes, and their physiologically acceptable salts which are useful as medicinal preparations in therapy and/or veterinary science for treating incontinence of urine in mammalians, in human beings, as well. Except this, the innovation refers to a pharmaceutical composition that contains the compounds mentioned.

EFFECT: higher efficiency.

1 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention relates to using of N-methyl-N[(S)-1-phenyl-2-((3S)-3-hydroxypyrrolidin-1-yl)ethyl]-2,2-biphenylacetamide or pharmaceutically acceptable salt thereof to produce drug for treatment of urinary bladder disorders. Also disclosed are pharmaceutical composition containing such compound.

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4 cl

FIELD: pharmaceutical chemistry and urology.

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2 cl, 1 tbl, 2 ex

FIELD: medicine, urology.

SUBSTANCE: at first, it is necessary to wash urinary bladder's cavity with ozone/NO-containing physiological solution. Then, 1-3 min later one should evacuate the worked out solution and introduce ozonide/NO-containing butyric "oil-in-water" emulsion into urinary bladder's cavity. Cavitary sonication should be carried out through the solution with low-frequency energy at 26.5 kHz frequency and fluctuation amplitude being about 60-80 mcm for 1-2 min. The worked out solution should be evacuated. Urinary bladder's cavity should be refilled in with fresh solution of ozonide/NO-containing butyric "oil-in-water" emulsion. One should affect with low-frequency ultrasound at fluctuation frequency of 44 kHz and amplitude of 25-30 mcm due to external contact impact upon the tissues of anterior abdominal wall in area of urinary bladder's projection. Moreover, it is necessary to simultaneously bubble the emulsion solution with ozone/NO-containing gaseous mixture for 1 min followed by aeration of urinary bladder's cavity with ozone/NO-containing gaseous mixture for 1 min. Application of such complex therapy enables to decrease urethral traumatism , intensify regional blood and lymph circulation in the area of urinary bladder, create the depot of medicinal preparation in tissue layers of urinary bladder's wall and fulfill sanitation of urinary bladder's walls.

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4 dwg, 2 ex

FIELD: medicinal industry.

SUBSTANCE: invention relates to a method for isolating biologically active substance from mammalian bladder and preparing a medicinal formulation for parenteral administration that can be used in medicine as an agent normalizing bladder tonus. Agent normalizing bladder tonus is made as a medicinal formulation for parenteral administration and represents peptide complex with the content of low-molecular fraction from 70% to 90%, molecular mass of its peptide components in the range from 74 to 394 Da and concentration of polypeptides 2.5-2.9 mg/ml. Agent is prepared from calf bladders (age is 12 months, not above) or pigs by extraction of tissue with acetic acid in the presence of zinc chloride. The proposed method for preparing agent normalizing bladder tonus from calves (age is 12 months, not above) or pigs involves defrosting tissue at temperature -40°C (not less), keeping at temperature -20-22°C for two months (not less) followed by milling and adding 3% acetic acid solution in the volume ratio = 1:5 at temperature 20 ± 5°C. Extraction is carried out at constant stirring and 1% zinc chloride solution is added to the prepared homogenous suspension in the volume ratio = 50:1 followed by cooling at constant stirring up to temperature 7-16°C and the following stirring for 1 h in each 4 h in settling for 48 h. Extract is separated from inert substances by separating, acetone is added to extract in the volume ratio = 1:5 and kept at temperature 3-5°C for 4 h. Formed homogenized deposit is precipitated repeatedly with acetone twice (not less) and deposit containing active substance is washed out on Nutch filter with two-fold volumes of acetone cooled to temperature 7-16°C up to preparing light-gray deposit. Deposit is rubbed through metallic sieve, dried, dissolved in distilled water at room temperature and constant stirring up to the concentration of polypeptides 2.5-2.9 mg/ml. Solution is centrifuged, filtered and subjected for ultrafiltration treatment in device under anti-pressure 1.0 kgf/cm2 (not above) through materials with retaining capacity 15000 Da. Glycocol is added to ultrafiltrate up to its final concentration 10-20 mg/ml at pH = 5.6-6.6, solution is subjected for sterilizing filtration under pressure 2.0 kgf/cm2 (not above), poured into ampoules in volume 2 ml and subjected autoclaving at temperature 120°C for 8 min and under atmosphere pressure 1.1 kgf/cm2. Invention provides optimal technology in isolating peptide complex with the content of low-molecular fraction from 70% to 90%, molecular mass of its peptide components in the range from 74 to 394 Da, and preparing aqueous solution of extract with the concentration of polypeptides 2.5-2.9 mg/ml/ Invention proves both purification of prepared product from impurities and to enhance its yield. The isolated substance differs from the known substances prepared early from mammalian raw by molecular mass of its peptide components, absence of toxicity and apyretic properties based on the complete removing impurities.

EFFECT: improved preparing method, valuable medicinal properties of agent.

3 cl, 2 tbl, 2 dwg, 5 ex

FIELD: medicine.

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4 cl, 12 tbl

FIELD: medicine.

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5 cl

FIELD: medicine.

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EFFECT: higher efficiency of therapy.

1 ex

FIELD: medicine, gynecology.

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EFFECT: higher efficiency of therapy.

1 ex

FIELD: medicine, in particular balneology and physical therapy.

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5 cl, 9 ex

FIELD: medicine, oncology.

SUBSTANCE: the present innovation deals with surgical therapy and chemotherapy. Moreover, in pre-surgical period it is necessary to sample 200 ml blood in such patients, due to centrifuging blood should be divided into plasma, leukomass and thromboerythromass. One should add leukovorin into the vial with leukomass at the dosage of 500 mg/sq. m to incubate in a CO2-incubator for 24 h and fluorouracil into the vial with thromboerythromass at the dosage of 1000 mg/sq. m to incubate for 30 min. Plasma should be frozen. In the course of the operation it is important to introduce intravenously by drops the content of the vial with thromboerythromass. On the next day the incubated leukomass with leukovorin should be injected for a patient intravenously by drops. Then, in post-surgical period on the 12th-14th d defrosted plasma should be incubated with fluorouracil at the dosage of 1000 mg/sq. m and metotrexate at the dosage of 25 mg/sq. m to be intravenously injected by drops. The innovation enables to decrease the frequency of relapses and metastases, decrease toxicity of anti-tumor preparations and prolong life period and improve quality of life in such patients.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: medicine.

SUBSTANCE: method involves taken patient blood in preoperative period in the amount of 200 ml. Plasma is separated from the blood by centrifuging. 40 ml of autoplasma and chemopreparation are introduced into the first flask. The remaining blood corpuscles, plasma and chemopreparation are enclosed in the second flask. The flasks are separately incubated for 40 min at 37°C. Then, operation is executed by subserously introducing autoplasma incubated with chemopreparation from the first flask along the tumor periphery before mobilizing large intestine. Intravenous drip-feed infusion of autoblood incubated with chemopreparation from the second

flask is concurrently carried out into peripheral vein.

EFFECT: enhanced effectiveness in preventing local relapses and metastases occurrence in remote period.

FIELD: medicine, pharmacy.

SUBSTANCE: invention relates to using blood plasma or serum as an agent for treatment of wounds and to a pharmaceutical composition used in treatment of wounds and comprising blood plasma or serum, and to a method for treatment of wounds by applying indicated composition on wound site for normalization of tissue medium around the wound site. Pharmaceutical composition for treatment of wounds comprises pharmaceutically effective amount of blood plasma and serum as an active agent with pH value in the range from 3.5 to 6.5. Invention allows using the composition for recovery, substitution, relieve, acceleration, assistance to healing and/or cure of any damaged or traumatized tissue. Also, invention relates to preparing the amount of such composition providing normalization of different activating cells of substance and pathological cells around the wound site and promotes to the wound healing.

EFFECT: improved and valuable medicinal properties of composition.

12 cl, 9 dwg, 15 ex

FIELD: medicine.

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EFFECT: maximum nociceptive pulsation blockade from surgical intervention zone; patient body temperature supported at the level of 36-37°C; prevented brain hyperthermia.

4 cl

FIELD: surgery, traumatology, orthopedics.

SUBSTANCE: method of preparing platelet-rich blood autoplasma for regeneration of cortical bone consists in adding it to autogenous stabilizer blood, centrifugation, adding pre-coagulant containing 10% CaCl2 solution, and a blood coagulation factor. Centrifugation is conducted at ambient temperature for 5-8 h at a rate of 1000-2300 rpm and than 5000 units of prothrombin (blood coagulation factor II) is added.

EFFECT: increased productivity of platelet-rich blood autoplasma preparation and reduced expenses owing to exclusion of expensive equipment.

FIELD: medicine, oncology.

SUBSTANCE: the present innovation deals with treating patients in case of skin melanoma stage III. For this purpose blood plasma should be incubated with the following chemopreparations: cisplatin 30 mg, metotrexate 5 mg, cyclophosphan 600 mg in a thermostat at 37°C for 30 min and in pre-surgical period it is necessary to inject it for a patient into subcutaneous fatty fiber due to paracenteses from 4 sides under the focus of malignant growth. During the same day it is important to star gamma-therapy at the dosage of 2.4 Gy daily for 5 d, then comes 1-d-long interval and the same order of procedures should be continued twice more. In 2 d one should carry out operation in the volume of wide dissecting the primary focus at regional lymphadenectomy. In 2 wk after operation - with the same preparations and at the same dosages 5 times every other week. During the next 2 yr it is necessary to carry out analogous adjuvant autohemochemotherapy once/3 mo. Application of the complex therapy suggested enables to achieve higher percentage of tumor regression, increase duration and improve quality of life.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: biotechnology.

SUBSTANCE: claimed method includes antigen production, producer hyperimmunization with said antigen, determination of immunogenic characteristics of producer blood and producer blood drawing followed by separation and conserving of target product. In producer blood serum antibody titer level to surface soluble Pasteurella antigens in passive hemagglutination reaction is determined. Producer blood drawing to obtain serum for treatment of pasteurellosis in pork is carried out at level of antibody titer to surface soluble P. multocida antigens of serological variants A, B, and D of 1:200-400, 1:400-800, 1:400-800, respectively. Producer blood drawing to obtain serum for treatment of pasteurellosis in cattle is carried out at level of antibody titer to surface soluble P. multocida antigens of serological variants A, B, and D of 1:32-400, 1:256-800, 1:128-800, respectively, and P haemolyca of biotype A-I of 1:128-256.

EFFECT: serum with increased specificity and activity.

2 cl, 5 ex

FIELD: medicine.

SUBSTANCE: method involves collecting blood plasma enriched in blood platelets, incubating it with heparin during 18-24 h at +4°-6°C, centrifuging it at 3500-4000 rpm at +4°-6°C and suspending the obtained precipitate in 50-70 ml of 7-7.5% sodium hydrocarbonate solution. The produced output product is frozen at -40-42°C and stored under these conditions.

EFFECT: high quality of preparation applicable for treating trophic ulcers, decubitus ulcers and other skin injury cases.

2 cl

FIELD: medicine, hematology.

SUBSTANCE: invention relates to development of novel fields in investigation of blood clot fibrin. Method involves dissolving fibrin isolated from human or animals blood clot in 18-22.5% sodium chloride solution and incubation at temperature 37-38°C for 18-24 h. Prepared fractions are separated in dividing funnel and fibrin physiological solution is prepared by addition of the corresponding amount of distilled water. Invention provides preparing fibrin fraction without using sodium hydroxide but by using neutral salt followed by addition of distilled water up to preparing fibrin fractions in sodium chloride physiological solution.

EFFECT: improved separation method of fibrin.

1 dwg

FIELD: medicine.

SUBSTANCE: one should introduce an endoscope into gastric cavity to obtain a chromatic video-image of the mucosa. It is necessary to detect the value of chromatic tinge of the video-image in chromatic system HSL ranged 0°-360°. One should predict the risk of hemorrhage relapse if chromatic tinge varies below 10°. The innovation enables to predict hemorrhage relapse with the help of the parameters mentioned.

EFFECT: higher accuracy of prediction.

3 dwg, 1 ex

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