Biomedical subjects
Publications and source records attributed to N A Nechiporenko.
A relationship between congenital features in the structure of rabbit kidneys and sensitivity to gentamicin nephrotoxicity was revealed. Gentamicin nephrotoxicity is more pronounced in rabbits with lower diameter of nephron convoluted tubules and with smaller cells lining their lumen.
This study included 15 patients with newly diagnosed prostate cancer with an average age of 71 years (62-85 years). The patients received Ukrain at a total dose of 100 mg (10 mg intravenously every second day, 10 injections altogether). After two to three injections of Ukrain, all the patients noted considerable subjective improvements in their state. Ukrain increased the amount of total T-lymphocytes, including "active" T-lymphocytes, decreased the content of T-suppressors and increased that of T helpers, correspondingly raising the T helper/T-suppressor ratio. Our results undoubtedly indicate the efficacy of Ukrain in the treatment of prostate cancer.
The aim of this study was to elucidate the mechanisms of the anticancer effect of Ukrain by comparing the processes of formation of the pool of free amino acids and their derivatives in the blood plasma and tumor biopsy specimens and unchanged bladder tissue in 28 patients with T1N0M0 bladder cancer. The examination was carried out before and after Ukrain treatment (10 mg i.v./day, for 20 days), which was combined with systemic chemotherapy for bladder cancer. Twenty-eight patients served as controls and received systemic chemotherapy only. Compared with healthy donors, the blood plasma of patients with urinary bladder cancer showed decreased concentrations of thiol-containing free amino acids and glutamine (Gln) and increased levels of nonessential (glutamic acid, proline, alanine) and aromatic (phenylalanine) free amino acids. In contrast to conventional chemotherapy, treatment with Ukrain eliminated the blood plasma amino acid imbalance in patients with bladder cancer, concomitantly enriching the pool of free amino acids and their derivatives in unchanged urinary bladder tissue and decreasing concentrations of Gln and leucine (Leu), regulators of malignant cell proliferation and differentiation, by 30-50%. In this situation, the concentrations of Gln and Leu in tumor tissue and the surrounding healthy urinary bladder tissue correlated highly significantly and negatively (r = -0.95). In conclusion, Ukrain prevents active free amino acid transport into urinary bladder tumor tissue, inhibiting the activities of protein biosynthesis, gluconeogenesis and energy production. The combined decrease in Gln and Leu levels in urinary bladder tumor tissue is a specific sign of the antitumor effect of Ukrain and a mechanism of its cancerostatic action by controlling the processes of amino acid pool formation in the tumor.
The aim of the present study was to evaluate the efficacy of Ukrain as a new treatment modality in 28 patients with stage T1N0M0 bladder cancer. The tumor dimensions varied from 0.5 x 0.5 cm to 3 x 4 cm. The first group (nine patients) was treated with a total dose of 100 mg Ukrain, the second group (10 patients) received 200 mg Ukrain, and the third group (nine patients) was treated with 300 mg Ukrain. In all patients Ukrain was administered i.v. at a dose of 10 mg per day. In the patients from the second and third group each course of treatment, consisting of 10 injections, was followed by 14 days of no treatment. Ukrain, at a total dose from 100-300 mg as neoadjuvant therapy in patients with T1N0M0 bladder cancer, resulted in either complete or partial regression of tumors in 60.7 +/- 9.2% of cases. The best treatment regime included three courses of Ukrain at 2-week intervals.
The results of organ-saving surgery performed for kidney tumor T1.2N0M0 in 21 patients are presented. The renal pole or a tumor-bearing sector of the parenchyma of the kidney was resected in all cases. Metastases developed in the retroperitoneal lymph nodes 6-9 months after pole resection in 2 cases of pT2N0M0 tumor in whom no lymphadenoctomy had been carried out. The remaining 19 patients have survived 6-48 months without any signs of recurrence or metastasis. Organ-saving surgery for kidney tumor T1N0M0 should be considered justified provided lymphadenectomy is performed.
The term "locally advanced cancer of the urinary bladder" is discussed. The data on examination and treatment of 375 patients are presented to work out criteria of diagnosis of the disease. Such patients have been shown to reveal extensive lesions from bladder tumor coupled with such homeostatic disorders as hypoamino-acidemia, endotoxicosis, metabolic acidosis, immunity deficiency and disturbed hemoglobin-mediated transport of oxygen. Early postoperative complication incidence can be cut by 30-47% and 3-year survival after cystectomy-increased by 19% provided said homeostatic disturbances are corrected and immuno- and biostimulation is carried out. The best results in the treatment of locally advanced urinary bladder cancer (T2(m)N0M0) were recorded among cases of organ-saving therapy-65-70% have survived 5 years. Only 36.4% of patients with tumor (T3abN0M0) who received complex treatment (cystectomy + preoperative homeostatic correction) have survived 5 years. None of the patients with tumor (T4N0M0) has survived 3 years; therefore, only radiation and chemotherapy should be recommended in such cases.
Five-year survival cumulative results have been used to assess the efficacy of treatment for locally extended carcinoma of the urinary bladder using different methods: radiation + resection of bladder + chemotherapy; radiation + cystectomy with ureterosigmoanastomosis+chemotherapy; radiation + cystectomy with ureterocutaneostomy + chemotherapy; chemoradiation treatment. In the group of patients with tumors T2(m)NoxMo, the best cumulative results for survival (65 and 70%) were obtained in cases of organ-saving surgery. In tumor T3a, bNox(+, -)Mo group, the best results for survival (31.3%) were registered in patients who had undergone cystectomy. Five-year survival level was not attained in patients with tumors T4a, bNox, IMo, which makes the case for chemoradiation treatment application.
Survival of 117 operable male patients who had refused treatment was compared to that of 267 male patients who had undergone radical therapy. It was shown that treatment did not influence five-year survival of patients with T cancer. The same tendency was observed for T4 tumors. Radical treatment was associated with a significantly longer survival in T2-3 cancer patients. In the T1-2 tumor group, mean survival following diagnosis was affected by patient age whereas the relationship was far less apparent in cases of T3-4 cancer.
Protein metabolism status was assessed by standard procedures versus tumor stage and nitrogen-excreting function of the kidneys in 250 cases of urinary bladder cancer. In addition, 18 amino acids in the blood were assayed in 63 patients. Standard methods of examination identified protein metabolism disturbances in patients with stage III-IV renal failure whereas amino acid profile showed changes at a much earlier stage. Patients with T3-4 tumors revealed decreased blood amino acid levels. Renal failure and surgical trauma caused the level of most amino acids checked to decrease. The need for correction of the amino acid profile of the blood before and after surgery is discussed.
Long-term results of cystectomy involving formation of ureterosigmoid anastomosis and ureterocutaneostomy were studied in 51 cases of cancer of the urinary bladder. Half the patients with T2 tumors and 23%--with T3 tumors survived for 3 years and longer. Tumor process generalization caused death long after operation in 64.2%, while renal failure--in 32.1%. During 1-2 years of follow-up, such pathological changes in uretero-intestinal anastomoses as abnormally large diameter of ostium ureteris and cicatricial stricture were identified in 14 cases and stricture of uretero-cutaneous stoma--in 2 cases. The best results in formation of ureterosigmoid anastomosis were obtained by application of transsigmoid procedures which assured reflux prevention, retention change-free ureters alone being eligible for use in anastomosis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The indications to putting in interrupted sutures on the urinary bladder after its resection for cancer are discussed. Based on the clinical observations, it is concluded that there cannot be any one-way approach to this problem. The bladder may be sutured, if the resection wound is located in the upper segment and anterior wall of the median segment of the vesicle in case of the unchanged detrusor vesicae and urethra, with low bacterial count of the vesical urine and providing for transurethral drainage of the vesicle by its drip irrigation. Interrupted sutures on the vesicle were used in 21 patients with favourable issues.
Explore the source record for details and available documents.