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Biomedical subjects

V N Stepanov

Publications and source records attributed to V N Stepanov.

At least 19 recordsLinked to original sources
PubMed1995

[Urinary excretion of leucine aminopeptidase after extracorporeal shock wave lithotripsy].

Extracorporeal shock-wave lithotripsy (ESWL) is the treatment of choice in the majority of urinary calculi. In experimental and clinical research it has been shown that the method has short-term deleterious effects on renal function. Several factors, such as urinary tract infection (UTI), the site of the stone, pre-existing renal abnormalities, the number and intensity of the shock waves may influence the extent of the damage. The aim of this study was to measure the excretion of the renal microsomal enzyme, leucinaminopeptidase (MLAP) as expression of renal damage following ESWL. Our study shows that there was a significant elevation in urinary excretion of MLAP immediately after ESWL, especially in patients with UTI. These results indicate that UTI may be one of the risk factors for aggravation of renal damage after ESWL. However, these changes are transient and expressed less than in patients with light renal trauma arising because of other external influence.

Adolescent↗
PubMedDate not supplied

Efficacy and tolerability of the lipidosterolic extract of Serenoa repens (Permixon) in benign prostatic hyperplasia: a double-blind comparison of two dosage regimens.

This 3-month double-blind, randomized, parallel-group study compared the efficacy and tolerability of two regimens of the lipido-sterolic extract of Serenoa repens (Permixon) (two 160-mg capsules once daily [OD] and one 160-mg capsule twice daily [BID]) in 100 outpatients with symptomatic benign prostatic hyperplasia (BPH). Both regimens significantly (P < .0001) reduced the International Prostate Symptom Score (I-PSS) mean total score from baseline; improvements achieved statistical significance after the first month and were maintained for the duration of the study. Significant (P < .05) and rapid improvements from baseline to the end of month 1 also occurred in I-PSS quality-of-life (QoL) scores, maximum and mean urinary flow rates, and residual urine volume; this benefit was further increased at month 3 for I-PSS total score and QoL and residual volume, and was maintained for maximum and mean flow rates. A highly significant decrease (P < .001) in residual urine was observed in both groups. No significant differences were noted between regimens. Clinical adverse events occurred at a similar incidence in both groups (BID, 24%; OD, 22%) and were deemed unrelated or unlikely to be related to Permixon.

Aged↗
PubMedDate not supplied

[Intraepithelial prostatic neoplasia].

44 patients seeked medical advice for low urinary symptoms. Their examination consisted of digital rectal investigation, test for prostate-specific antigen (PSA) in the serum, transurethral ultrasonic investigation, fine needle multifocal biopsy of the prostate. Three groups were identified by the PSA levels. 7 patients of group 1 had PSA up to 6 ng/ml. Cancer was diagnosed in 3 of them, prostatic intraepithelial neoplasia (PIN) in 4 patients. 16 patients of group 2 had PSA within 7-10 ng/ml. In this group only 1 patient had cancer, the rest 15 had PIN. 21 patients of group 3 with PSA at least 10 ng/ml had cancer, benign prostatic hyperplasia, PIN (12, 2 and 7 patients, respectively). 3 patients with high-grade PIN and PSA above 10 ng/ml in 6 months were diagnosed to have adenocarcinoma, in 6 such patients signs of dysplasia disappeared after antiandrogenic therapy. Further investigations on diagnosis and treatment of PIN are desirable.

Biomarkers, Tumor↗
PubMedDate not supplied

[Chronic obstructive prostatitis].

The authors review current classifications of chronic prostatitis and propose their own classification which reflects routes of prostatic infection, division of infectious prostatitis into obstructive and non-obstructive forms, etiology of chronic prostatitis. Original methods and facilities for prostatic drainage via transurethral and transrectal approaches are described.

Chronic Disease↗
PubMedDate not supplied

[Acute scrotum: clinical picture, diagnosis, treatment].

The purpose of this study was to evaluate the potentialities of ultrasonic dopplerography and radioisotope scanning of the scrotal organs for the diagnosis of acute scrotal diseases and defining the indications to surgery in patients with acute epididymoorchitis. A total of 128 subjects were examined (23 healthy controls and 105 patients with scrotal diseases). 139 ultrasonic and 76 radioisotope scannings of the scrotum were carried out. Ultrasonic scanning plays the key role in the diagnosis of traumatic and inflammatory epididymoorchitis. Radioisotope study is more informative in the diagnosis of torsion of the testicle. The data indicate high informative value of ultrasonic and radioisotope studies in differential diagnosis of acute scrotal diseases and diseases simulating an acute process in the testicle and appendage. A positive feature of both methods is the possibility of their repeated use for evaluating the treatment efficiency. Analysis of 241 cases with acute epididymoorchitis showed that early surgical treatment of patients with pyodestructive inflammation promotes rapid recovery. Ultrasonic monitoring helps timely detect the complications and correct the treatment strategy. Wide use of ultrasonic and radioisotope methods of examination in patients with acute scrotal diseases promote timely detection of pathological changes and better results of treatment.

Acute Disease↗
PubMedDate not supplied

[Change in anatomo-functional state of the parenchyma in early unilateral renal cell carcinoma before and after surgical treatment].

The aim of the trial was to study compensatory potential of renal parenchyma in the presence of renal cell carcinoma (RCC) and after organ-saving and radical surgical treatment as shown by one-photon emission computed tomography (OPECT). OPECT before the treatment and 6 and 12 months after it evidences that in unilateral RCC, irrespective of the focus location, both kidneys as a single organ respond to tumor growth with compensatory hypertrophy. Compensatory reserve is limited. In tumor size more than 6 cm the affected kidney starts losing the volume of the functional tissue while infiltrative growth is most likely. Assessment of the compensatory potential of the kidneys provides additional information. If the volumes of the kidneys differ by more than 30%, RCC growth is infiltrative. In this case only radical nephrectomy is recommended. If the size of the kidneys is by 60% more than normal one and parenchymas of the affected and contralateral kidney reach their compensatory limit but are equal, indications to organ-saving surgery extend as greater hypertrophy of the remaining kidney is excluded. After organ-saving surgery, a compensatory increase was observed in the contralateral kidney. This is explained by effective distribution of protein material and separate processes of proliferation (healing) and hypertrophy (compensation). Assessment of anatomo-functional condition of renal parenchyma helps better selection of patients for organ-saving surgery.

Adult↗
PubMedDate not supplied

[Ultrasound studies in varicocele].

Renal function, the anatomic and functional status of the vena cava inferior, renal arteries and veins, and spermatic veins were evaluated in healthy individuals and patients with varicocele before and 12 months after laparoscopic ligation of the left spermatic vein. The renal vessels were assessed by color Doppler ultrasonography and renal function was examined by complex radionuclide study with 99mTc-pentatech. There were no significant changes in the diameter of renal arteries and vena cava inferior and the right arterial blood flow velocities in healthy individuals and patients. No difference were found in the diameter of renal veins and in the blood flow velocity in renal arteries and veins. The enlarged renal veins and decreased mean blood flow velocity in the left renal vein in healthy persons and patients with varicocele and lower blood flow in the left renal artery than in the right one indicate left-sided renal hypertension that is attributable to left renal vein overload due to a great variety of collaterals and to compression at the site of "a forcepts". At the same time 12-month postoperative ultrasonic, Doppler and complex radionuclide studies revealed no significant changes in the diameter and blood flow velocity in the left renal vein.

Blood Flow Velocity↗
PubMedDate not supplied

[The role of transperitoneal fine-needle aspiration biopsy in the diagnosis of obstructive uropathy in patients with cervix uteri cancer].

Upon the exposure to remote or combined radiotherapy, the patients with uterine cervical cancer often develop ureterostenosis due to recurrence or postradiation alterations in the walls and adjacent tissues of the ureter. Etiology of the urodynamic defect is essential for the treatment policy choice. Therefore, in attempt to find out effective means of differential diagnosis between ureteral obstruction due to cervical cancer relapse and due to postradiation lesion, the authors tried transperitoneal aspiration biopsy with thin needle as a tool of such diagnosis. The biopsy was obtained from 19 females. In 14 of them the obstruction was attributed to recurrent cancer, in 5 to radiotherapy. No errors in the diagnosis were made. Thus, the accuracy of the method reached 100%.

Adult↗
PubMedDate not supplied

[Emission-computed tomography in the diagnosis of kidney tumors and cysts].

Emission computed tomography (ECT) was used to examine 48 patients with suspected renal lesions. Sectional images of renal cysts diagnosed in 14 of them were characterized by well-defined outlines surrounded by uniformly declining radiopharmaceutical accumulations. Renal tumors were detected in 25 patients. ECT pattern of the tumor had obscure borders suggesting the tumor invasion into the renal tissue. Accumulation of the radiopharmaceutical round the tumor was less pronounced than in functioning renal tissue. According to ECT findings, 8 subjects were free of urological pathology. It is concluded that ECT is a promising diagnostic tool in urology as it permits sectional visualization of renal neoplasms structure, is highly sensitive, informative and noninvasive. It can identify mass lesions of the kidneys and warrants exhaustive information on functional performance of the renal parenchyma.

Aged↗
PubMedDate not supplied

[Transabdominal and transurethral scanning in the diagnosis of the bladder cancer stage].

Diagnostic potential in staging cancer of the urinary bladder was evaluated in 54 relevant patients aged 37-74 for transabdominal versus transurethral ultrasound scanning. In transabdominal scanning stages T2 and T3 cannot be distinguished separately, stage T1 was recognized definitely in 66.6%, T2-T3 in 65.6%, T4 in 70% of cases. Transurethral scanning appeared valid in staging T1 in 91.6%, T2 in 88.8%, T3 in 92.8%, T4 in 90% of cases. Histological studies in 54 patients showed that transurethral scanning can provide accurate results in staging cancer of the urinary bladder in 90.7% of cases. The findings support clinical value of the method as highly informative in staging cancer of the bladder. Basing on both transabdominal and transurethral scanning, ultrasound picture for each stage of the cancer was characterized.

Abdomen↗
PubMedDate not supplied

[The combined treatment of urinary incontinence after adenomectomy].

Treatment was applied in 55 patients with enuresis after removal of adenoma of the prostate. Nonoperative treatment of 46 patients included therapeutic exercises, drug therapy (anti-inflammatory agents and tonics), and physical methods: transurethral direct electrical stimulation of the vesical sphincters (25 patients), transperineal ultrasonic stimulation (21 patients). After nonoperative treatment enuresis was completely cured in 31 patients. Fifteen patients with poor results were subjected to a second course of treatment: a satisfactory result was produced in another 6 patients, an improvement was recorded in 9 patients. Operative treatment was carried out in 9 patients: 4 of them by A. Puigvert's method (satisfactory result in 1, improvement in 1, poor result in 1, acute ischuria in 1) and 5 by a modified Puigvert's operation the techniques of which consisted in forming 2 rectangular grafts from the tunica albuginea of the cavernous bodies of the penis, suturing the medial grafts to one another above the urethra on the midline, and suturing to their bases the lateral grafts (satisfactory results in 4, improvement in 1). Thus, complex treatment of 55 patients for enuresis consequent upon removal of adenoma of the prostate caused a satisfactory result in 42 (76.4%), an improvement in 11 (20%), and a poor result in 2 (3.6%) patients.

Aged↗