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Patients with system lupus erythematosus, rheumatic arthritis, chronic active hepatitis and gout were found to have considerable hyperuricemia and be decreased in aminoacides content, which are the predecessors of purine. Hyperactivity of xanthineoxidase and POL content were also revealed. The close correlation relation of purine indices of such patients has been observed. The obtained data allow applying methods of correction of immunity system and purine metabolism to these patients by introducing in a complex therapy inhibitors of xanthineoxidase.

The article presents a comparative analysis of methods for quantitative assessment of roengenologic changes in the joints in rheumatoid arthritis that have come to be widely used in USA and Europe. It is noted that the Steinbroker's method widely employed by clinicians fails to give an integral assessment of the articular affection. Expediency is documented of employment of the Sharp's method in roentgenologic monitoring in clinical trials of new antirheumatic drug preparations. In a routine clinical setting the Larsen's method or its modifications are to be preferred since in spite of its low sensitivity investigation time is cut down 2.3-fold by comparison with the Sharp's method.

To study dynamic surface tension (DST) of blood and urine in SLE patients.Clinical, immunological examinations, DST of blood and urine using computer tensiometers were made in 67 SLE patients aged 15 to 62 years.Changes in interphasic tensiograms in males and females were characterized regarding the course, activity of the pathological process and the presence of certain clinical symptoms. Effective therapy return to normal DST of the biological fluids. Correlations between interphasic tensiograms of blood, urine and levels of proteins, lipids, non-protein and inorganic surfactants and surface-inactive substances were established as well as relations of DST with biochemical composition of the biological fluids.The above diagnostic method may be useful for differential diagnosis, assessment of the clinical course, activity of the disease, control over effectiveness of the treatment.

Chronic dust bronchitis in miners is associated with increase in dynamic surface tension of blood at short (t = 0.01 s) and medium (t = 1 s) surface lifetimes with lower declination angle of interphase tensiograms curve. Surface tension disorders were similar to those in experimental dust bronchitis. There are correlations between surface tension parameters and the workers' underground length of service, some mining geologic conditions and serum level of proteous and lipid surfactants.

The disease was simulated by inhalation of dust containing 29% of free silica in Wistar male rats during 8 months. One group of the subjects was kept under 26-28 degrees C and other one--under 38-40 degrees C. Dynamic surface tension of lung tissue homogenate was studied by means of computer tensiometer MRT (Lauda, Germany). Interphase tensiometry precisely characterizes state of lung surfactant in experimental chronic dust bronchitis. Equilibrium surface tension and surface tension for 0.01 and 1 sec deteriorate during combined exposure to silica dust and heating microclimate. The studies demonstrated strong correlation between interphase tensiogram parameters and individual lipids content of lung surfactant. Surface tension is related to the state of lipids peroxidation in lungs and antioxidant systems.

Dynamic superficial tension (ST) of spinal fluid (SF) and blood serum in patients with CNS tumors was investigated. The maximum bubble tension was measured by a MPT2 computer tensiometer (LAUDA). There were decreases in ST of blood serum at t = 1 and t--infinity, increases in ST at t = 0.01 and decreases in the angle on SF tensiograms. The parameters of interphasic tensiometry of the biological fluids depend on content of biologically active substances severity of the neurological symptomatology and duration of disease. Successive surgical treatment is followed by normalization of SF and blood serum ST.

An improved version of the MPT2 (LAUDA) computerized tensiometer (Germany) was used to measure dynamic surface tension (ST) of blood and urine by the maximum bubble pressure method in patients with tumors of the uterus, vagina and cervical canal. Relatively low blood and urine ST values at t--infinity and serum at t = 1 s were registered. Combined radiotherapy involved oppositely-directed changes in the equilibrium (static) ST of the biological fluids as well as a urine ST inhibition in the surface short-life range (t = 0.01 s). The slope of blood serumtension curves by the end of treatment was close to that in healthy females.

Experiments on 24 Wistar male rats were performed to clarify the role of central mechanisms in the onset of electrical instability of the heart due to disturbances in purine metabolism. The activity of the enzymes responsible for synthesis and conversion of adenosine-5-nucleotidase and adenosine deaminase in the sensomotor cortex, hypothalamus and hippocamp was studied. Changes in cardiac function were most severe in high levels of adenosine in the neurons of the sensomotor cortex, hypothalamus and hippocamp. Minimal changes occurred in low content of adenosine in the hypothalamus and hippocamp.

Assessment of the dynamic surface tension (DST) of blood serum (BS), synovial fluid (SF) in various courses of rheumatoid arthritis (RA).Forty three patients with RA and 63 apparently healthy individuals were examined. DST of BS and SF was determined in the computer-aided tensiometer and some blood biochemical parameters were also measured.DST of BS in patients with RA were found to be higher than the normal values and some parameters c beta 2 and beta 3) of BS DST did not significantly differ from the normal values whereas others (beta 1 and gamma proved to be much lower. Depending on the disease course variants, there were some differences in these DST changes. There was a feedback between DST parameters and the levels of immunoglobulins, beta 2-microglobulin, and lipids in blood.Assessment of BS and SF DST may be useful in the differential diagnosis of RA, in the determination of its intensity and prognosis, and therapeutical efficiency.

Dynamic surface-tension (S-T) was investigated of blood and urine of healthy individuals and patients with chronic glomerulonephritis by the proposed method of maximum pressure in a bubble with the aid of the computer-assisted device tensometer MPT-1 (Lauda, Germany). Patterns of changes in dynamic and static S-T were found out as were those of the slope of the curve in patients with mesangioproliferative and mesangiocapillary variants of the condition, in nephrotic syndrome and chronic renal insufficiency. Correlation type comparison was performed of physical-and-chemical properties of biological fluids to parameters characterizing protein and fat exchange. Relationship between dynamic S-T and biochemical composition of blood and urine was revealed. Diagnostic value of results of the studies made is discussed.

Coal miners suffering from rheumatoid arthritis (RA), deforming osteoarthrosis (OA) and gouty arthritis (GA) were found to develop hypotestosteronemia in a study on the condition of the hypophysis-and-gonads system, this being observed even in essentially healthy individuals. With all arthronoses, androgen levels get depressed, particularly so in the presence of increased activity of lutropin. In RA examenees blood concentration of estradiol tends to increase, while OA and GA miners demonstrate reduced content of estrogen, with manifest hyperprogesteronemia being common. Hormonal dysbalance correlates with gravity of the course of the inflammatory-degenerative processes in the locomotor system.

The studies covered serum levels of total and ionized calcium (Ca), parathyroid hormone (PTH), calcitriol (Ctr) and calcitonin (Ct) in miners assigned to various occupational groups and suffering from deforming osteoarthrosis. Ratio of calcium clearance to glomerular filtration rate was assessed. Ionized Ca appeared to decrease along with increase of PTH and Ctr. Changes in Ca homeostasis were proved to depend on occupation, geologic conditions in the mines (depth, ambient temperature of the workplace), presence of chondrocalcinosis.

An immunologic evaluation was done in healthy miners and those working in coal mines suffering from deforming osteoarthrosis. Blood levels of beta 2-microglobulin and circulating immune complexes, titres of antibodies to glycosaminoglycans and antigens from cartilaginous tissue and synovial membrane were all found to be elevated. Shifts in the immunity system were clearly related to the spread of the pathological process as well as the rate of the disease progression and presence of reactive synovitis but not with occupation of the patients. Clinico-immunologic manifestations of osteoarthrosis were unfavourably influenced by industrial mining-geological factors.

Gonadotropic function of hypophysis was studied in 109 patients with gout. Raised level of luteinizing hormone (LH) was found in men while women had decreased content of LH and follicle-stimulating hormone (FSH). Severe lesions of joins and kidneys were associated with suppressed FSH secretion. The authors consider correction of hormonal dysfunction in gout to be advisable. Certain correlative relations were established to exist between levels of gonadotropins, sex hormones and indices of purine metabolism.

Alpha-tocopherol acetate produced a positive effect on the renal function in patients with nephrogenous hypertension due to replenishment of endogenous antioxidants and its regulatory effect on lipid peroxidation. As a result there occurs a reduction of highly-toxic products of lipid peroxidation, improvement of renal microcirculation, reduction of ischemic disorders in the organs of the body.

The examination of 241 gout patients (207 males and 34 females) revealed a marked sexual dimorphism of the disease related to the articular and renal syndromes. Male gout is characterized by higher blood levels of uric acid and oxypurinole in reduced clearance of the latter, while in female gout there were hyperxanthinoxidasemia and hypo-cAMPemia. Unbalance of sex and gonadotropic hormones, which appeared multidirectional and dependent on the sex, was observed in males in the form of lower concentrations of blood testosterone and estradiol against elevated levels of progesterone and lutropin, in females manifested with hypoprogesteronemia and reduced gonadotropin.

The analysis is given to experience in teaching clinical nephrology to subinterns at a therapeutic chair. The initial knowledge in nephrology assessed in undergraduates proved unsatisfactory. Guidelines are presented for lecturers as well as results of questioning surveys of the students. The students answers showed that individual clinical tasks appeared most difficult for them. The mean score fr home tasks was 3.1, good marks being given in 21% only. Poor knowledge was reported in resolving diagnostic questions, treatment of renal failure, treatment of the kidneys in systemic disorders of the connective tissue. The post-study test control stated considerable gain of relevant knowledge.

Upon the analysis of qualitative and quantitative characteristics of hematuria in renal and urinary tract affections it was established that whatever the red blood cell count in the urine, hematuria is primarily glomerular in contrast to nonglomerular in chronic glomerulonephritis and nonglomerular diseases of the kidneys and urinary tracts, respectively. Morphologic studies of urinary red blood cells using phase-contrast microscopy proved a valuable tool for identification of hematuria origin.

The study of urinary sediment is essential in laboratory diagnosis. Conventional clinical methods are now used in line with computer-aided techniques and additional microscopy of the sediment elements. The paper provides a brief analysis of clinical situations characterized by appearance in the urine of abnormal numbers of leukocytes, erythrocytes, casts; provides clinical assessment of additional microscopic methods able to accentuate qualitative characteristics of the urinary syndrome; considers possibilities of application of the urinary sediment data in follow-up to improve diagnosis and control on-going treatment.

The authors investigated the functional state of the liver and lipid peroxidation in vasorenal hypertension. Results indicate that the functional state of the liver in vasorenal hypertension is disturbed as a result of the main renal disease and also under the effect of arterial hypertension as a destabilizing factor leading to disorders of the hemodynamics and furthering potentiation of lipid peroxidation processes in the body.

An analysis was made of some immunological indices in patients with podagra. It was established that women showed a more pronounced reduction of T-lymphocytes in the peripheral blood and their functional activity in tests with phytohemagglutinin and concanavalin as well as a deficit of B-lymphocytes, hyperproduction of C-immunoglobulin and antibodies to DNA in the blood serum. Males showed an increased level of B-lymphocytes. M-immunoglobulin and antirenal antibody titers. The concentration of circulating immune complexes in the blood rose equally independent of age.

Male patients with gout exhibit a decrease in the blood content of testosterone and estradiol and an increase in the content of progesterone. The amount of androgen and estrogen changed insignificantly but the level of gestagen abruptly dropped in female patients. Irrespective of the sex the concentration of lutropine and follitropine appeared to be decreased. Whereas the level of uric acid in men was in inverse relation to the production of estradiol, in the group of women--to the indices of progesteron. Changes in sex hormones depended on the form of arthritis and the type of nephropathy.

The authors analyze the course and outcomes of 33 pregnancies in 26 women suffering from systemic lupus erythematosus (SLE). In patients with active SLE the incidence of gestoses and abnormalities of the newborns is significantly higher than in those with inactive SLE, whose gestational and neonatal complication rate is almost the same as in healthy women. Pregnancy course and outcomes are particularly unfavorable in cases with lupus glomerulonephritis.

The authors studied the content of beta 2-microglobulin (beta 2-MG) in the blood serum and its excretion with the urine in 85 patients with chronic and 35 with lupoid glomerulonephritis (CGN and LGN) depending on the activity of the disease and state of the renal function. In active CGN and LGN one could observe a distinct increase of the content of beta 2-MG in the blood serum and an increase of its excretion with the urine that may be related to presence of marked dystrophic changes of the canalicular apparatus of the kidneys leading to disorders of reabsorption and beta 2-MG catabolism as well as disorders of the immune homeostasis revealed in these diseases. Results indicate that the beta 2-MG levels in the blood serum and urine may be considered as criteria of CGN and LGN activity.

Problems of pathogenesis, diagnosis and therapy of gout and chondrocalcinosis in which deposits of uric acid salts and calcium are found in the articular tissue are of primary importance in modern rheumatology. The authors give observations of 10 out of 218 patients with primary gout in whom roentgenology had revealed signs of calcium salt deposits in the joints and periarticular tissue.

The efficacy was studied of using allopurinol in 68 patients with primary podagra. The obtained results were compared with the treatment of 118 other patients who received similar treatment but without allopurinol (zanthinoxidase inhibitor). Allopurinol increased essentially the efficacy of therapeutic measures though positive dynamics concerning the renal process was achieved in 1/3 of patients.

Results are presented of an investigation of birefracting fatty bodies in the urine of patients with primary chronic lupoid and Henoch glomerulonephritis. There was a close correlation between the presence of birefracting fatty bodies and severity of glomerulonephritis independent of the morphological picture of the disease and state of renal function. Reduction of the activity of the disease in the course of pathogenetic treatment characterized by a decrease or disappearance of proteinuria was accompanied by a distinct reduction of the level of birefracting fatty bodies or their disappearance.

Glomerulonephritis with minimal alterations presents one of the most complex problems of nephrology. The authors provide the data on the disease incidence and clinico-laboratory correlations in 33 adult patients, discuss problems of the treatment policy.

Patients with different types of podagric nephropathy were examined for 21 indicators of the functional activity of T and B lymphocytes and neutrophils. The data obtained were compared to the degree of impairment of the basic renal structures. Among the study immunologic indicators to estimate the gravity of morphological alterations in the glomeruli, the decrease of the titers of antibodies to DNA is of definite specificity, whereas the fall of the concentration of circulating immune complexes is of definite specificity in the assessment of alteration in the stroma.

The authors revealed heart failure in 7 of 216 patients with gout. Two of them showed isolated mitral valve insufficiency and two patients aortal insufficiency while combined aortal disease, combination of mitral and aortal insufficiency and combined mitral valve disease with aortal insufficiency occurred each in 1 patient. One could not find distinct dependence between the clinical variant of the course of gout and development of a definite heart failure. Clinical and electrocardiographic signs of the revealed kinds of cardiac abnormalities are described. The morphological changes of the valves are described on the basis of 2 autopsy cases. The possible mechanism of development of podagric heart failures is discussed.

The levels of aberration of chromosomes in peripheral blood leucocytes were investigated in patients with chronic and lupoid glomerulonephritis considering the clinical variants and morphological forms of the disease. In chronic glomerulonephritis high levels of chromosome aberration were found in patients with nephrotic type; in lupoid glomerulonephritis the frequency of chromosome aberration was higher in patients with active glomerulonephritis. Chronic renal failure did not essentially change the level of chromosome aberration both in chronic and lupoid glomerulonephritis. In different morphological forms of glomerulonephritis the frequency of chromosome aberration was determined by the clinical variant of the disease.

The efficacy of isolated and combined treatment of renal lesions sallopurionol (milurit), potassium orotate, azathioprin (6-mercaptopurin) was studied in 207 inpatients with primary podagra. Citrate mixtures, urinary antiseptic and hypotensive agents were used when indicated. Follow-up results from 1 to 12 years are analyzed. Prolonged systematic complex treatment of podagric nephropathy is medically and economically effective.