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Biomedical subjects

D Iu Pushkar'

Publications and source records attributed to D Iu Pushkar'.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[Screening for prostatic cancer].

The discussion covers different aspects of application of programs of early prostatic cancer diagnosis. Arguments for and against the screening are presented. The existing methods of early prostatic cancer diagnosis are reviewed. How to improve the technique of taking prostatic biopsy is shown.

Adult↗
PubMedDate not supplied

[Radical prostatectomy: surgical techniques and preliminary results].

Prostatic cancer (PC) is a frequent finding in aged men. In fact, 3% of males have the chance to die of PC. Radical prostatectomy by the retropubic approach with pelvic lymphadenectomy was made in 97 males. The treatment was performed in the urological department of the MSMSU urological chair from 1995 to 2001. 69 patients followed up for 3-64 months after the operation were eligible for analysis of the outcomes. The patients had the following PC stages: T1--11 patients, T2--44 patients, T3--14 patients. Prostate-specific antibodies ranged within 2.9-67.8 ng/ml (the mean level 16.7 ng/ml). The results of the treatment were satisfactory in 65 (94.2%) of 69 patients. The operation did not take more than 2.5 hours, mean blood loss was under 870 ml. Adequate urination after the catheter was removed resumed in 41 (59.4%) of 69 patients. Active urinary incontinence was observed within one year after the operation in 25 (36.2%) patients, total incontinence--in 3 (4.3%) patients. 51% patients retained the erectile function after nerve-sparing operation. Most of the patients had an unevenful postoperative period. During the follow-up 3 patients died of acute myocardial infarction (n = 1), intestinal cancer (n = 1) and distant PC metastases (n = 1). A postoperative fall in the PSA level under 0.3 ng/ml occurred in 49 (71%) patients, under 2 ng/ml in 7 patients (10%). In 19% of patients with pT2-3 the PCA rose over 2.0 ng/ml. Radical prostatectomy is indicated for patients with local prostatic cancer (stage T1 or T2) and probable survival from 10 to 15 years and longer. A nerve-sparing, sphincter-sparing and ablastic variant of this operation is widely used world-wide and is a method of choice for therapy of patients with retropubic prostatic cancer.

Adult↗
PubMedDate not supplied

[Pinpointing the stage of prostate cancer after radical prostatectomy].

AIM: To analyse data of the preoperative examination of patients and histomorphological examination of prostatectomy samples to determine parameters allowing staging prostatic cancer (PC). MATERIAL AND METHODS: 27 patients with staged clinically diagnosed PC have undergone radical prostatectomy with histomorphological examination of the intraoperative samples of the prostate. RESULTS: The preoperative evaluation of PC has revealed no cases with Glisson's scale (GS) score under 5. Only 8.7% of the tumors were well differentiated, of them 28.3% had the score 7 and higher. 85% of the cases were moderately differentiated adenocarcinomas with the score 5 to 7. 33.3% patients had cancer diagnosed by prostatic biopsy (T1c). Nearly 48% had the tumor T2b, T2c. Histomorphologically, 50.7% of tumors were advanced. A high PSA level, a high score by Glisson and a clinical stage of the tumor at least T2b indicated high probability of extracapsular spread and of metastases to the lymph nodes each. The Glisson's score was higher at analysis of prostatectomy samples than prostatic biopsy in 10 (37%) cases while it was lower only in 2 (7.4%) cases. In 5 (18.5%) patients the difference made up 2 and more scores by Glisson. CONCLUSION: Thin needle biopsy examinations underestimate PC stage. To stage and predict the disease course precisely it is necessary to make a multifactor analysis.

Aged↗
PubMedDate not supplied

[Spasmex treatment of patients with hyperactive urinary bladder].

Overactive urinary bladder (HAUB) is encountered in 16-20% patients with various voiding disorders. Etiologically, detrusor hyperactivity can be neurogenic and idiopathic. We studied efficacy of the antimuscarine drug spasmex in patients with imperative voiding disorders and compared its efficacy and tolerance with those of driptan and detrusitol. 193 female patients with imperative voiding disorders were examined. Spasmex given in a dose of 5 mg 3 times a day for 12 weeks produced a good effect in 56 patients: increased the effective capacity of the urinary bladder, reduced the number of voidings and episodes of incontinence for a day. A 3-month course of spasmex proved highly effective as shown by the patients' subjective response and positive changes in objective evidence. Being equally effective with detrusitol and driptan, spasmex is much superior to oxibutynin in safety.

Benzhydryl Compounds↗
PubMedDate not supplied

[Combination surgery in radical nephrectomy].

In 18 of 487 patients (11 males, 7 females) operated for renal cancer, radical nephrectomy was made simultaneously with cholecystectomy (n = 14) and prosthetic repair of the abdominal aorta (n = 4). A transabdominal approach was used in all the cases. Duration of radical nephrectomies from the transabdominal approach varies from 95 to 180 min while simultaneous operations lasted from 130 to 228 min. Cholecystectomy increased duration of the operations by 25-55, aortic repair--by 60-90 min. Conduction of concomitant operations had no negative effect on the course of postoperative period or on the number of complications. 18 cases of simultaneous operations (radical nephrectomy and cholecystectomy or aortic repair) showed that there was neither increased number of complications nor duration of hospital stay. Cholecystectomy can be made from the same incision as radical nephrectomy whereas aortic repair demands the middle approach which is not convenient for performance of radical nephrectomy.

Adult↗
PubMedDate not supplied

[Gentos in the treatment of chronic abacterial prostatitis].

Gentos was given to 46 patients with chronic abacterial prostatitis. The results of the treatment were analysed for 39 of them. Compared to control group, efficacy of gentos was 64.5-71.8% versus 53.6%. It can be used both as monotherapy and in combination with other modalities. Side effects of gentos were not registered.

Adult↗
PubMedDate not supplied

[An expanded technique of transrectal prostatic biopsy].

To compare diagnostic value of transrectal prostatic biopsy in obtaining samples of tissue from different sites in patients with various levels of prostate-specific antigen (PSA) and prostate size, we made primary transrectal biopsy of the prostate in 486 patients. The patients were divided into 7 groups by the number of punctures at biopsy (from 6 to 18). Among the patients with PSA under 20 ng/ml in the number of tissue biopsy samples 18, a rise in prostatic cancer detection rate (PCDR) was 16.6%. In PSA above 20 ng/ml, a statistically significant maximal rise in PCDR occurred in the increase of biopsy number from 6 to 12 (by 9.3%). The number of local cancer forms in patients with PSA < 20 ng/ml among all the detected cases rose from 70% (biopsy from 6 sites) to 92.3% (biopsy from 18 sites). Among the patients with PSA < 20 ng/ml and the size of the prostate > 50 sm3, a significant rise of PCDR increased from 20 to 33.3% in an increase of the puncture number from 6 to 12. In the group of patients with the same PSA level and prostate > 50 cm3 PCDR improves in biopsy from 14, 16 and 18 sites (from 12.1 to 27.7%, 28.5 to 33.3%, respectively). Standard biopsy is insufficient for adequate PCDR, it is necessary to obtain samples of tissue from a large number of sites with puncture of peripheral zone of the prostate. Transrectal biopsy of the prostate according to the extended method improves PCDR, primarily, in local cancer.

Biopsy, Fine-Needle↗
PubMedDate not supplied

[Viagra effects on polysystemic energy metabolism in stress (an experimental study)].

Experiments on 40 white rats were made to study effects of cardura (doxasozine) and viagra on polysystemic energy metabolism in stress. All the animals were examined for cytochemical activity of succinate dehydrogenase, lactate dehydrogenase in blood lymphocytes, antioxidant activity of blood plasm, levels of hydroperoxides, malonic dialdehyde. 3-hour immobilization raises functional activity of mitochondria manifesting with intensification of energy metabolism. Adrenoreceptors blockade by cardura prevents changes in the cellular metabolism. The same antistress effect is observed in viagra action. This newly discovered mechanism may prevent complications of adrenergic reactions accompanying sexual intercourse.

Animals↗
PubMedDate not supplied

[A new pathogenetic approach and a method of erectile dysfunction treatment and prevention--modulated erectile oxygenation of penile cavernous tissue].

The analysis of sexual activity of 185 male Muscovites has revealed an age-related sharp progressive shortening of adequate and spontaneous erections. A novel, pathogenetically sound approach and a method of therapy and prevention of erectile dysfunction has been developed (RF patent N 2228754). The method, called "Modulated Erectile Oxygenation of Penile Cavernous Tissue" (MEOPCT), consists in erection activation by behavioral measures and/or erectogenic drugs which induce adequate, nocturnal spontaneous and/or artificial erections adequate in frequency and duration for providing such oxygenation of cavernous bodies that warrants maintenance of their normal structure and function. There is no continuous close correlation between sexual activity and erections, on the one side, and ejaculation and orgasm, on the other side. Application of MEOPCT in 43 patients demonstrated the method ability to improve erection and cavernous hemodynamics without negative side effects.

Adult↗
PubMedDate not supplied

[Intravesical ionophoresis of medicines (an experimental study)].

The depth of drug penetration into the wall of the urinary bladder in intravesical ionophoresis (IVIP), IVIP influence on functional condition of the lower urinary tracts were studied on 15 female dogs. Functional condition of the lower urinary tracts was characterized by pressure in the urinary bladder, "volume-pressure" index, bioelectric activity of the urethra. The pressure was registered by electromanometry. Bioelectric activity of the urethra was studied with electromyography and tetrapolar rheography. The above indices were registered synchroneously on a multichannel recorder. Intraoperative cystomanometry was made in 7 tyopental narcotized animals. Samples of blood and vesicular tissue were taken for immunofluorescent study before and after IVIP. Medicines were accumulated best in mucous and submucous layers (0.039 +/- 0.0012 and 0.0338 +/- 0.0050 mcm/mg tissue, respectively). After IVIP intravesical pressure was, on the average, lower in the same filling volumes as before IVIP. A mean amplitude of spontaneous fluctuations of pressure in the urinary bladder in its filling after IVIP was also lower than the baseline. After IVIP, pressure in the urinary bladder in voiding was much lower than before the procedure, maximal capacity of the urinary bladder and elasticity of the wall increased. Bioelectrical activity of the urethral wall was registered in the same mean pressure and capacity as before IVIP. Intensity of micturition after IVIP course decreased both at rest and in diuretic load with lasix. Time to micturition was increased with an increase in the number of procedures of IVIP. Thus, the experimental study showed pathogenetic validity of intravesical ionophoresis of medicines in the treatment of chronic recurrent cystitis.

Administration, Intravesical↗
PubMedDate not supplied

[Complications of transrectal biopsy of the prostate].

The aim of the study was to assess frequency of various complications of transrectal multifocal biopsy of the prostate (TMBP), to specify prophylactic measures against such complications. Primary TMBP under US guidance was made in 612 patients (mean age 65.8 years, mean level of PSA 12.6 ng/ml). TMBP complications include: hematuria (220 patients, 35.9%), hemospermia (166 patients, 27.1%), pain in the perineum and the rectum (189, 30.9%), acute prostatitis (21 patients, 3.4%), acute orchiepididymitis (7 patients, 1.1%), acute urine retention (9 patients, 1.5%), long-term rectal hemorrhage (13 patients, 2.1%), loss of consciousness during the biopsy (7 patients, 1.1%). The analysis of TMBP complications leads to the conclusion that adequate preparation of the patients and accurate conduction of the prostatic biopsy technique under US guidance make this invasive manipulation diagnostically effective and safe.

Aged↗
PubMedDate not supplied

[A retrospective analysis of morphological tests in patients with interstitial cystitis].

Cystoscopy, hydrobougieurage and biopsy of the urinary bladder were made in 80 female patients with interstitial cystitis (IC) aged 23-68 years. Endoscopic changes were estimated by an original scale. The analysis of the endoscopic findings revealed a correlation between duration of the process, cystoscopic picture and histopathological evidence. Clinical and cystoscopic pictures provide significant information on morphological changes in the wall of the urinary bladder depending on the disease stage. Histological study of urinary bladder biopsies in IC is used rather for excluding other diseases of the urinary bladder with similar clinical symptoms (primarily cancer and tuberculosis).

Adult↗
PubMedDate not supplied

[Effects of parallel ultrasonic visualization of the prostate in sagittal and cross projections in transrectal biopsy on detectability of prostatic cancer].

The results of 526 transrectal prostatic biopsies are available. Mean age of the patients was 64.6 years, mean level of PSA--10.4 ng/ml, mean size of the prostate--56 cm3. Biopsy was made in visualization of the prostate in the sagittal projection (ultrasound devices Bruel & Kjaer 1846 and Kretz Voluson 730). Application of Bruel & Kjaer Medical 2102 Hawk provides visualization of the prostate during biopsy both in sagittal and cross projection. Double visualization significantly improved detectability of prostatic cancer in patients with PSA 4-10 ng/ml. In biopsy of the top and peripheral zone there was lengthening of prostatic tissue fragments, reduced fragmentation of the columns, less frequent blank shots of the biopsy gun. The data obtained supports the importance of isolated placement and marking of prostatic tissue fragments in biopsy and allow to recommend wide clinical use of ultrasonic facilities with biplanic sensors providing online sagittal and cross visualization of the prostate.

Aged↗