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Biomedical subjects

S B Urenkov

Publications and source records attributed to S B Urenkov.

At least 19 recordsLinked to original sources

[Vascular endothelial growth factor in patients with prostate cancer and benign prostatic hyperplasia].

The authors examined 25 patients with prostate cancer (PC) and 36 patients with benign prostatic hyperplasia (BPH). In the group of patients with morphologically verified PC mean serum level of vascular endothelial growth factor (VEGF) was significantly higher than in patients with BPH (p < 0.05). The study demonstrated strong negative association between VEGF and prostate specific antigen (PSA) levels (r = 0.72, p < 0.05) in PC patients. There was no association between VEGF serum level and the stage or malignancy of PC (Gleason score). In benign prostatic glands moderate VEGF expression was observed only in basal cells, whereas in cases of PC all tumor cells displayed active VEGF expression; the difference was significant (p < 0.05). High serum VEGF levels and its active expression in patients with PC suggest an important role of angiogenic factors in the pathogenesis of this disease. The negative association between VEGF and PSA serum levels in PC indirectly confirms antiangiogenic activity of PSA, shown before.

Aged↗

[Current approach to solving the problem of urolithiasis].

The article analyses experience in the management of about 1,500 patients with urolithiasis who underwent in- and out-patient treatment at the Urological Clinic of the Moscow Regional Scientific Research Clinical Institute in 1990-1993. Indications were determined for applying lithotripsy in patients with stones in anomalous kidneys, in cases of a solitary kidney, and children with urolithiasis. The tactics of management of large kidney stones is described. The use of endoscopic methods of treatment (percutaneous and transurethral) is evaluated. Modern methods of urolithiasis treatment were applied instead of an open operation in 90% of patients.

Adolescent↗

[Comparative evaluation of two methods for the uretero-cystic anastomosis].

Comparative analysis of two types of ureterocystic anastomosis in kidney transplantation showed the advantages and shortcomings of the method developed at the Moscow Regional Scientific Research Clinical Institute. The new anastomosis fundamentally differs from the traditional Mebel-Shumakov method in the absence of sutures between the ureter and the bladder mucosa. This feature makes it possible to avoid injury to the bladder mucosa which is often changed in prolonged anuria and reduce the edema and ischemia of the terminal part of the ureteral graft. This facilitates adaptation of the anastomosis to polyuria which often occurs in the early postoperative period. The relatively simple techniques shortens the time needed for the operation. These advantages of the new method of ureterocystotomy are manifested by decrease of the total number of urological complications and the relative incidence of serious early urological complications like fistula of the ureterocystic anastomosis and necrosis of the ureter which most often lead to loss of the transplant and sometimes to death of the patient. The use of the anastomosis developed at the Clinical Institute, however, is attended by a relatively high incidence of ureteral stricture in the late-term postoperative period, evidently due to prolonged contact of urine with the bladder muscular coat and the ureteral adventitia. Thus, the more favorable results of ureterocystic anastomosis formed by the method developed at the Clinical Institute allow it to be recommended for further use in kidney transplantation.

Anastomosis, Surgical↗

[Telemetric shock-wave lithotripsy on a new Russia LGK-Kompakt 9701U lithotriptor].

During clinical tests of a new Russian [symbol: see text]K-Kom[symbol: see text]akt 9701[symbol: see text] lithotriptor, the Urological Unit of the Moscow Regional Research and Clinical Institute performed 73 sessions of telemetric shock-wave lithotripsy (TIWL) in 43 patients with urolithiasis (20 females and 23 males whose age ranged from 23 to 78 years). The tests indicated that the new device meets all present medical and engineering requirements for lithotriptors having an ultrasound stone-picking-up system and has some advantages over the analogues made in foreign countries in both medical and engineering indices. The device provides good images of renal calculi and destroys them effectively, of peripelvic and intramural portions of the ureter, and the urinary bladder. A positive effect of TIWL was achieved in 37 patients (calculous fragments moving away in full), minor calculous fragments remained in 6 patients (their treatment is under way). No complications associated with the action of shock waves generated by the [symbol: see text]K-Kom[symbol: see text]akt 9701[symbol: see text] lithotriptor on the kidney and adjacent organs were observed during the clinical tests. Post-TIWL control follow-ups (within the first 24 hours to 6 months after TIWL) revealed no noticeable structural changes in the renal parenchyma or worse renal function.

Adult↗

[Extracorporeal shock-wave lithotripsy of bladder stones in patients with benign prostatic hyperplasia].

In urological department of Moscow Regional Research Clinical Institute, extracorporeal shock-wave lithotripsy (ECSWL) or bladder stones in patients with benign prostatic hyperplasia (BPH) has been made prior to TUR from 1991. This treatment was given to 52 patients aged 54-79 years with prostatic volume 40-120 cm3. Complete or partial fragmentation of the vesical calculi was achieved after 1 to 3 ECSWL sessions (a total of 105 sessions, 2000-3000 impulses a session). Pretreatment with ECSWL of bladder stones significantly facilitates TUR in BPH patients with vesical calculi of big size (2.5 cm and more in diameter). Extracorporeal fragmentation of large stones prior to TUR makes surgery of such patients less traumatic and reduces the risk of intraoperative complications compared to endoscopic cystolithotripsy or cystolithotomy. ECSWL of cystolithes expands indications for drug therapy or thermal non-endoscopic BPH treatment in aged patients with poor somatic status and in young sexually active males rejecting surgery.

Aged↗

[Vascular endothelial growth factor and insulin-like-growth factors in prostate cancer. ].

To study the levels of vascular endothelium growth factor (VEGF), insulin-like growth factor of type I and II (IGF-I and IGF-II), prostate-specific antigen (PSA) and their correlations in prostatic cancer (PC) and benign prostatic hyperplasia (BPH), we examined 38 PC patients (mean age 66.6 +/- 5.5 years) and 80 BPH patients (mean age 60.3 +/- 2.5 years). Serum concentrations of VEGF, IGF-I and IGF-II were measured using kits made by R&D (USA), PSA by Boehringer Mannheim (Germany). Sensitivity and specificity of the tests were analysed by plotting the curves. The serum VEGF concentration in PC patients was 518.9 +/- 60.7 pkg/ml, in BPH patients--267.9 +/- 99.9 pkg/ml (p < 0.001). The IGF-I and IGF-II it was 178 +/- 19 and 136 +/- 9 ng/ml (p < 0.05), 400 +/- 31 and 351 +/- 23 ng/ml (p < 0.05), respectively. The ratio of growth factor concentration to PSA concentration in the blood serum in BPH patients was higher than in PC patients (p < 0.01). Sensitivity and specificity of PSA (4 ng/ml) made up 85.7 and 57%, VEGF (151.5 pg/ml)--76.2 and 57.6%, IGF-I (157 ng/ml)--57.6 and 50%; IGF-II (392 ng/ml)--57.5 and 50%, respectively. Sensitivity and specificity VEGF/PSA was 85.7 and 70%; IGF-I/PSA--84.2 and 75%; IGF-II/PSA--84.2 and 79.6%, respectively. Thus, the ratio of concentrations of IGF-I, IGF-II and VEGF to PSA level in blood serum has high sensitivity and specificity for PC detection. Clinical implications of serum levels of VEGF, IGF-I and IGF-II for prediction of PC course and detection is to be elicited.

Adenocarcinoma↗

[Comparative analysis of open and endoscopic operative procedures outcomes for posterior urethra obliteration in males].

Endoscopic recanalization of posterior urethra (PU) obliteration (a novel method) was compared to open reconstructive-plastic operations. 242 patients with PU and vesicular cervix obliterations entered the study. 93 patients of group 1 have undergone open reconstructive-plastic operations, 149 patients of group 2 were operated endoscopically (endoscopic recanalization under transrectal ultrasonic control). Before surgery the patients were examined using standard tests, sonourethrography and intraoperative transurethral ultrasonic investigation were added. Recurrence rate in group 1 and 2 was 29.1 and 16.8%, respectively. The following complications were observed in group 1: acute pyelonephritis (22.5%), enuresis (14%), orchoepididymitis (9.7%), urinary fistulas (5.4%). The patients needed long-term postoperative immobilization (10-16 days, mean 14.8 +/- 1.1 days). After endoscopic recanalization under transrectal ultrasonic control, group 2 patients developed acute pyelonephritis (4.8%), orchoepididymitis (4%), orthostatic enuresis (4%), short-term urethral fever (85.9%). Bed regime in this group was necessary for 1-2 days (1.3 +/- 0.4 days). Mean postoperative hospital stay was 2.5-fold less in group 2. The conclusion is made that endoscopic recanalization under transrectal ultrasonic control has advantages over open reconstructive-plastic surgery: less frequent pyoinflammatory complications, enuresis, the absence of such complications as impotence, short penis, formation of urinary fistulas.

Adolescent↗

[Use of ureteral stents in patients with kidney transplantation].

The aim of the study was to determine indications for application of ureteral stents for draining urinary tracts of the renal transplant, after low-invasive surgical interventions, for timing drainage, prevention and correction of complications. Ureteral stent insertion for management of urological complications after transplantation of the kidney was made in 36 patients (25 of them have ureteral stricture, 11 had ureteral necrosis). Low-invasive operations were made in 28 patients, open reconstructive plastic operations were conducted in 12 patients. According to 6-12 follow-up of the stented patients, recurrent ureteral stricture was detected only in 4 patients (11.1%). The stricture was corrected transcutaneously by antegrade ureteral stenting. It is concluded that stenting of the urinary tracts of the transplanted kidney in the treatment of urological complications--necrosis and ureteral stricture--in the course of low-invasive roentgenoendoscopic and open reconstructive-plastic operations raises treatment efficacy and prevents recurrent stricture.

Cystoscopy↗

[Hyperthermia as a method for treating prostatic adenoma].

Local microwave hyperthermia was used in 15 patients aged 60 to 76 years with prostatic adenoma on an inpatient (n = 8) and outpatient (n = 7) basis. Severe clinical symptoms of prostatic adenoma was considered indication and urinary and prostatic stones were contraindications. Every patient received 6 hyperthermia treatments (41 to 42 degrees C) with a 915 or 460 MHz device. Adenoma of the prostate was treated twice a week. An interval of 3-4 days was used to avoid thermic tolerance. The treatments were well tolerated. Prostatic size was reduced by 15.2 cm2 in 11 patients and unchanged in 1 patient. Three patients required surgery 2 weeks after treatment withdrawal because of adenoma distension with residual urine and 3 patients were operated on for cystostomes. The overall effect of microwave hyperthermia on prostatic adenoma was induction of focal sclerosis in adenoma. This treatment improved uroflowmetric findings and abolished residual urine. Hyperthermia is a reasonably safe conservative option for inoperable patients with prostatic adenoma.

Aged↗

[Ultrasonic study in the diagnosis of developmental defects and diseases of the urinary system in children].

Echography has recently become one of the leading methods of examination in different branches of medicine. Despite its high informativeness, however, it is not used widely in pediatrics. The article generalizes the practical experience accumulated in ultrasonic examination of urinary organs in children with developmental anomalies and diseases of the kidneys, ureters, urolithiasis, and Wilms' tumor. Besides, the possibility of echography as a screening test in outpatient examination of children with changed values of urinalysis is shown for the first time in pediatric practice. The authors describe the advantages of the method in combined developmental anomalies and regular medical examination of patients after various methods of treatment. They emphasize its merits (absolute safety, no injurious effect, high informativeness, the possibility of performing it in children who are in a grave condition, its extensive use under outpatient conditions, etc.). It is shown the ultrasonic examination in outpatient clinics makes it possible to divert from the traditional plan of radiourological examination of children, which includes excretory urography performed in children in inpatient clinics as a rule. It is obvious that the use of echography as a diagnostic test will make it possible to exclude the radiation load which is most harmful for the growing and developing organism and will not require mass hospitalization, which will undoubtedly have a high therapeutic and economical effect.

Adolescent↗

[Ultrasonic diagnosis of ureterocele].

Diagnostic ultrasonic investigation has found many applications in routine urologic practices. The use of ultrasound for the investigation of 19 patients with ureterocele is reported. High diagnostic value, simplicity and noninvasiveness of echographic diagnosis of this congenital malformation of distal ureteral portions and related complications are pointed out. Its advantages over conventional means of ureterocele diagnosis, such as excretory urography and cystoscopy, are demonstrated, while their shortcomings are avoided. Echography is particularly effective in cases of impaired renal activity, doubled upper urinary tract and segmentary ureterohydronephrosis. Ultrasound makes it possible to choose the type of surgical intervention, and exclude angiography from the diagnostic complex in some cases. Follow-up echographic examination after surgery for ureterocele provides adequate information on treatment results.

Adult↗

[Urolithiasis in children].

The paper reviews the experience of the urological clinic in the treatment of 106 children with urolithiasis. The necessity of careful pretreatment examination to reject associated anomaly of the upper urinary tracts as a cause of lithogenesis is emphasized. Surgical treatment and extracorporeal lithotripsy which has proved highly effective against uroliths in children are considered.

Adolescent↗

[The ultrasonic diagnosis of vesicoureteral reflux].

Potentialities of ultrasonic investigation (USI) in diagnosis of vesicoureteral reflux (VUR) were elucidated by comparison of the USI evidence with that obtained at miction cystourethrography which had identified VUR of degree I-IV. Ultrasonic signs of active and passive VUR distinctly observable in the reflux degree III and IV are noted. The technique of USI in VUR-suspected children is described. Ultrasonic measurements of the intravesicular part of the lower ureter were made. It is shown that USI can serve a method of outpatient selection for miction cystourethrography. As demonstrated by the examination of 58 patients with transplanted kidney, USI is effective in identification of the reflux to the transplanted kidney as well as in differential diagnosis with obstructive complications after transplantation.

Adolescent↗