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Biomedical subjects

Kh Kumanov

Publications and source records attributed to Kh Kumanov.

At least 19 recordsLinked to original sources
PubMed1991

[The diagnosis, biopsy and treatment follow-up via ultrasound in patients with prostatic carcinoma].

According to data available in the literature prostate cancer accounts for 0.2 to 0.4 percent of all cancer diseases, 1 to 5 per cent of all tumors in males and 29.2 per cent of the tumors affecting the urogenital system. The consensus today is that prostate cancer is the most common tumor of the urogenital system. It is a disease of the advanced age, being most common in the age group 60 to 70. It is pointed out that transrectal echography has gained acceptance basically for the diagnosis of prostate cancer, for determining its stage and for check-up of the effect of treatment. According to M. Devonec et al., J. Pointes et al, the specificity of this method is 79 per cent and its sensitivity 48 per cent. The echographic diagnostic criteria for prostate cancer are described. The value of transrectal echography increases when performed with biopsy specimen examination under ultrasound control, especially in nonpalpable neoplasms or when digitally directed biopsy specimens have yielded doubtful or negative result. The method is noninvasive, practicable and well tolerated; this makes it particularly valuable for control of the effect of treatment.

Aged↗
PubMed1991

[A comparative evaluation between transrectal echography, venous urography, computerized axial tomography and morphology in patients with prostatic carcinoma].

Prostate cancer is a rather common and severe disease in man. It affects the age beyond 50, a tendency being recently observed towards affecting subjects of younger age. In the early stage the symptoms are scarce and vague. The diagnostic possibilities of ultrasound examination, intravenous urography, computer axial tomography and biopsy specimen examination were compared in patients with prostate cancer. The authors consider the possibilities of transabdominal and transrectal echography for diagnosis of prostate cancer to be superior to those of intravenous urography. H. Watanabe even recommends and uses transrectal echography as screening method. The possibilities and results of transrectal echography and computer axial tomography for evaluating tumor growth and infiltration outside the prostate capsule are compared. Ultrasound examination is recommended as a more exact method, with a view to radical prostatectomy. The good correlation of the echographic patterns with tumor development are also recorded.

Aged↗
PubMed1991

[The early scintigraphic diagnosis of bone metastases in prostatic carcinoma].

Fifty-nine patients, 58 to 88 years of age, with prostate cancer comprise the study group. Screening studies were made in doubtful diagnosis and vague complaints, as well as repeated scintigraphic controls in histologically proven cancer. The most common localization of the bone lesions were: pelvis, ribs, lumbar and thoracic vertebrae. Distribution of the zones of enhanced drosition, effect of treatment and eventual connection between scintigraphic and histologic finding are noted. Patients without X-ray evidence of bone metastases or with evidence of single metastases, frequently had extensive dissemination of the metastatic process when whole-body bone scintigraphy was made.

Aged↗
PubMed1991

[The place of interventional ultrasound in urology].

The search for new methods of diagnosis, treatment and prognosis and their introduction in practice is a stable process in world urologic practice. It was not until after the first echographic apparatuses were produced in the fifties that the introduction of interventional ultrasound in urology became feasible. The authors set themselves the task to study and summarize the possibilities of this method for treatment of diseases of the kidneys, upper urinary tract, bladder and prostate. Renal cysts were diagnosed by ultrasound in 312 patients; in 229 of them percutaneous puncture was performed under ultrasound control. To reduce relapses, different sclerosing substances were applied, peak success being obtained with tetraolean. For establishing the exact cause of obstruction of the upper urinary tract the authors used antegrade pyelography under ultrasound control in 92 patients. Percutaneous nephrostomy for drainage of the upper urinary tract, a new endourologic operation was performed in 67 patients. To raise the radical approach to transurethral resection of the prostate and of bladder tumors, intraoperative transurethral ultrasound control was adopted for all patients operated by this technique.

Adult↗
PubMed1990

[A case of tertiary hyperparathyroidism following kidney transplantation complicated by lithiasis].

For the first time in Bulgaria the authors present a case of tertiary (autonomous) hyperparathyroidism, persisting in a patient who had successful kidney transplantation. Subtotal parathyroidectomy six months after the transplantation led to complete cure. Associated with the underlying disease, a rare complication was also observed in the patient--calculosis in the grafted kidney, spontaneously eliminated 40 days after the parathyroidectomy.

Adult↗
PubMed1990

[Cases of the regression of advanced bladder tumors (T2-T4) after the use of chemotherapy].

A. Yagoda reports that modern therapeutic schemas applied for treatment of bladder tumors have essentially increased the response rate: more than 50 per cent with full response (CRs), within the range from 28 to 40 per cent persisting for a period from 11 to more than 32 months. What appears new, noted by this author, is the complete disappearance of the tumor (restaging) following chemotherapy, demonstrated surgically and on pathologic examination. Proceeding from the current trends in the treatment of bladder tumors and the use of modern chemotherapeutic schemes, the authors describe 4 cases of regression of advanced tumors. This was based on criteria of clinico-laboratory assay, which included urethroscopy with transurethral echography and biopsy specimen examination, computer axial tomography of pelvis and kidneys, radioisotopic examination of kidneys, chest X-ray. Two patients received combined treatment by a scheme with methotrexate, biocysplatinum and biocarbazine; a three-year survival without relapse was recorded. The other two patients were treated using M-VAC scheme (methotrexate, vinblastine, adriamycin and biocysplatinum). They have been under observation for 18 months and had no relapse.

Aged↗
PubMed1989

[The current concept of tumor markers in oncologic urology--cytoplasmic markers].

The cells of testicular tumors and other malignant processes synthesize specific proteins which may be demonstrated intracellularly and may be quantitated in the patient serum. Of major value as markers in testicular tumors are alpha-fetoprotein and human choriongonadotropin. Radioimmune methods allow detection of minimal amounts of these substances at a moment when there are on other criteria for the presence of malignant process in the organism. This helps to establish early diagnosis and detection of relapses, precise determination of the stage and monitoring of treatment. Methods have also been developed for intracellular localization of the tumor markers, which allow precise diagnosis at cell level and retrospective studies on fixed biopsy specimens. The immunohistochemical classification which has been established and the experience being gained allowed the approach to the treatment of testicular tumors to be based in a major extent to the tumor markers.

Biomarkers, Tumor↗
PubMed1989

[Orthoclone OKT3 (Muromonab CD3)--the indications for and manner of its use. Side effects and their prevention].

In the last decade renal transplantation has gained considerable development. This is due to the achievements of clinical immunology and refinement of the surgical technique. In spite of all this, the achievements of renal transplantation are variable. This primarily is due to T-lymphocyte mediation, causing hazards for graft rejection. At present, numerous therapeutic agents, blocking the immune response of the organism, are applied. They are most effective when block selectively the activity of the immune cells responsible for immune response. The first synthesized preparation is Orthoclone OKT3 (Muronab-CD3). It is a sterile solution of murine monoclonal antibody to T3 (CD3) antigen in human T-cells and functions as immunosuppressor. The first experimental data on its application have been published in 1975. In 1980 the preparation was applied for the first time for treatment of acute reaction for grafted kidney rejection. The authors set themselves the task to give a brief review of the nature of this preparation, mode of its storage, indications for use, side reactions and their prophylaxis.

Antibodies, Monoclonal↗
PubMed1989

[The current concept of tumor markers in oncological urology--cell surface markers].

Basic problem of the diagnosis and treatment of superficial noninvasive bladder cancer is the absence of criteria for its potential invasiveness. In recent years it became clear that cell differentiation in some cancer forms essentially depends on the presence or absence of some antigens on the cell surface. These may be demonstrated by means of appropriate methods and may thus serve as marker in determining the prognosis and the stage of the disease and for monitoring the therapy in patients with bladder carcinoma. Of major value for the clinical practice are the clinical practice are the T-antigen, the ABO(H) antigens and the tumor-assisted antigens. Demonstration of T-antigen is effectuated by means of a modified erythrocyte-binding test and of the ABO(H) antigens by the Davidsohn's test. Correlation of these antigens with the pathological and clinical stage in a series of studies has demonstrated their practical significance in choosing an optimal therapeutic plan. There also exists relationship between the blood group antigens and the degree of malignancy in urothelial tumors. This allows a more precise evaluation of the indications for organ-preserving operation in some cases.

ABO Blood-Group System↗
PubMed1989

[Modern principles of the treatment of testicular tumors].

The modern principles of treatment of patients with germinative tumors of the testis are discussed. Essential are precise morphologic diagnosis and exact determination of the stage of the disease. Preference is given to the so called surgical-pathological staging, because it furnishes major objective information. Of the noninvasive methods of examination major value have computer axial tomography, measurement of the serum alpha-fetoprotein, human choriongonadotropin and SB1 levels, lymphography and pulmonary tomography. The role of tumor markers as criteria for early diagnosis of relapses and objective assessment of the effect of treatment is emphasized. The place of chemotherapy depending on the histologic variant and the stage of the process is determined. The results of modern chemotherapeutic schemes, which have shown statistically greatest effectiveness are discussed. The place of supra- and infrahilar lymph dissection as method of diagnosis and treatment is arguable. Some records (randomized) for treatment of germinative tumors of the testis, which might serve as practical guidance are presented.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[The clinical course and diagnosis of urogenital fistulae of obstetrico-gynecologic origin].

Ninety two women with urogenital fistulas of obstetric-gynecological origin comprise the study group. In 23 patients (25 per cent) urine outflow from the vagina started immediately after the operation and in 69 (75 per cent) from the 3. day to 2.3 years after childbirth, obstetric operations and manipulations, gynecological and urogynecological operations, irradiation and nonsurgical gynecological diseases. Colpitis had 62 (68.9 per cent) of 90 women subjected to vaginal examination. Eighty patients (87 per cent) had clinical evidence of urinary tract infection and 92.2 per cent laboratory data. Predominated gram-negative bacterial causative agents. Impaired renal function including lack of function was demonstrated in 96.9 per cent of the patients with ureterovaginal fistulas, demonstrated by excretory urography, isotope nephrography and renal scintigraphy, whereas renal function in patients with vesicovaginal and urethrovaginal fistulas remained intact for a long time. In the authors' opinion, most important diagnostic methods are excretory urography, dye tests, cystoscopy with retrograde ureteral catheterization and ureteropyelography. Isotope methods of examination and renal echography are of major value for diagnosis of uretero-vaginal fistulas. Early in 1988 vaginography was included in the group of methods for diagnosis of urogenital fistulas.

Bacteriuria↗
PubMed1989

[The surgical treatment of urogenital fistulae of obstetrico-gynecologic origin].

Ninety-two patients with urogenital fistulas of obstetric-gynecological origin have been treated at the Department of Urology of the Medical Academy in Sofia for a period of 14 1/2 years. Eighty seven women (94.6 per cent) were operated, with a total of 97 operations being performed. Thirty two of 34 patients with ureterovaginal fistula were operated (94.1 per cent). The following operative interventions were performed: 1 definitive nephrostomy, 5 temporary relieving nephrostomies, 4 nephrectomies and 27 reconstructive ureteral operations. Of 51 patients with vesicovaginal fistulas, 48 were operated (94.1 per cent). The following operations were performed: 4 supravesicular derivations of the urine, 21 transvaginal fistulorrhaphies, 16 transvesical suturings of the fistula, 11 transperitoneal and 1 transperitoneal-transvesical fistulorrhaphies. Seven women with ureterovaginal fistulas were operated transvaginally. The time elapses from the appearance of the fistula to the reconstruction was 66.2 days in ureterovaginal fistulas and 5.8 months in vesicovaginal and ureterovaginal ones. Transurethral urinary drainage was the operative method of choice. Eighty-three per cent of the operated patients were cured after the first correcting operation in patients with vesicovaginal and urethrovaginal fistulas. Best were the postoperative results in patients with ureterovaginal fistulas after ureterocystoneostomy by Bömonghaus's method.

Female↗
PubMed1989

[The M-VEC chemotherapy of advanced bladder tumors].

The authors have treated 34 patients (32 men and 2 women) with advanced transient-cell bladder tumors. Depending on the degree of their infiltration, the tumors were divided in two groups: I. Locally advanced resectable tumors T2-T3B--25 patients, in 16 of whom TUR and in 9 open operation was performed; II. Locally advanced nonresectable tumors T3B-T4--9 patients, 8 of whom were not operated and in 1 ureterocystoneostomy was performed because of hydropyonephrosis. Modified M-VAC chemotherapeutic scheme was applied--M-VEC (epirubicin was substituted for adriablastin): methotrexat 30 mg/m2, vinblastin 3 mg/m2, pharmorubicin 30 mg/m2, biocysplatinum 70 mg/m2. This constellation was applied as adjuvant therapy for group I patients and as nonadjuvant for those of group II. The patients received from 1 to 4 treatment courses. The results of the postoperative application in group I patients were: 7 of those treated with M-VEC after TUR have no recurrence for a period of 12 months and 9 are still under treatment; 4 of the open operation group + M-VEC have no recurrence for 12 months and 4 are still under treatment. In group II where M-VEC was applied as nonadjuvant therapy partial remission was recorded in 3 patients. The authors' early studies on the M-VEC chemotherapeutic scheme in advanced bladder tumors assert the data of other authors: as adjuvant chemotherapy it guards against recurrences, as nonadjuvant may make 50 per cent of the patients operable; reducing the tumors to stages T0, T1 or T1S makes cystectomy unnecessary, thus preserving bladder and sexual function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Adjuvant chemotherapy with biocisplatin, methotrexate and biocarbazine in advanced bladder tumors].

In a series of 44 patients with advanced nonmetastatic bladder tumors the authors carried out complex treatment: operative removal of the tumor with subsequent (adjuvant) chemotherapy. Tumor transurethral resection (TuTUR) was performed in 26 patients and open operation in 18. The chemotherapeutic scheme included: biocysplatinum 60 mg/m2, methotrexat 15 mg/m2 and biocarbazin 200 mg/m2. Each patient received up to three therapeutic courses. The following late results were obtained: For a period of 6 to 12 months in 3 patients the tumor progressed and two of them died; twenty three patients, i.e. approximately half of the patients in this series (52.2 per cent) had no recurrences until the end of the second year. There was on essential difference between the number of recurrence-free patients for two years between the two approaches: TuTUR + chemotherapy--14 patients (53.8 per cent) and those subjected to open surgery + chemotherapy--9 patients (50 per cent). For a period of 3 years 12 patients had no recurrences (27.2 per cent). The most common side reactions to chemotherapy were leucopenia and vomiting. A few patients had transient renal dysfunction.

Adult↗