Saratov JOURNAL of Medical and Scientific Research

2012, volume 8

Professor Andrey Vasilevich Belskiy (to the 100th anniversary)

Year: 2012, volume 8 Issue: №4 Pages: 1027-1029
Heading: Scientific schools Article type: Review
Authors: Bluvshtein G.A., ZavyalovA.I.
Organization: Saratov State Medical University, Regional Hospital
Summary:

The article presents biography of professor»s A. V. Belskiy. It reflects his scientific and practical contribution to the development of the most significant directions in Russian medicine including professional training of Health Service specialists.

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Main stages in formation and development of Department of General Hygiene and Ecology of Saratov State Medical University (for the 100th anniversary)

Year: 2012, volume 8 Issue: №4 Pages: 1023-1027
Heading: Scientific schools Article type: Review
Authors: Eliseev Yu.Yu., Zavyalov A.I., Lutsevich I.N., Alekseeva N.I.
Organization: Saratov State Medical University
Summary:

The history of formation and development of Department of General Hygiene and Ecology from the moment of its foundation till the present has been considered in the article. The basic directions in research work of employees of department have been presented. The scientific and practical contribution of Saratov scientists to the development of sanitary service and hygiene in Russia and preparation of medical professionals has been shown.

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Methodological aspects of health care professionals training

Year: 2012, volume 8 Issue: №4 Pages: 1017-1022
Heading: Pedagogics and Education Article type: Review
Authors: Protopopov F.F., Erugina М.V., Korshever N.G., Sidelnikov S. A., Zavaleva E.V
Organization: Saratov State Medical University
Summary:

The research goal is to prove the necessity of realization of principles and provisions of the theory of systems and research conducted on the basis of the methodology to optimize the process of health care professionals training. Methods of theoretical and methodological analysis of scientific literature, study of office and medical documentation, social investigation of experts in the field of health care management, doctors and officials of administration of one of the municipal areas have been used.

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Prevention of papillosphincterotomic wound bleeding after endoscopic intervention on major duodenal papilla in choledo-cholithiasis

Year: 2012, volume 8 Issue: №4 Pages: 1012-1016
Heading: Surgery Article type: Original article
Authors: TolstokorovA. S., Sarkisyan Z. О., Goch Е.М., Skopets S. М., Dergunova S. A., Rakhnayev D. Y. Parab D.
Organization: Saratov State Medical University
Summary:

Objective of the study is to prevent bleeding from papillosphincterotomic wounds after endoscopic intervention. Methods: Analysis of the results of endoscopic intervention of patients receiving treatment at the Saratov regional hospital during the period from 2006 to 2010. Endoscopic papillotomy and papillosphincterotomy have been performed in 250 patients. Bleeding has been occurred in 21 (8.4%) of cases. Results: Bleeding from the PST or PT — wounds has occurred in self-discharge of CBD stones into duodenum. Conclusion: According to the observations, method of prevention of bleeding from PST-wound in choledocholithiasis has been proposed. It deals with the temporary installation of stent in the distal part of common bile duct for 2-4 days in multistage endoscopic operations.

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Morphological changes of tissue in implantation of xenopericardium and polypropylene net after surgical intervention

Year: 2012, volume 8 Issue: №4 Pages: 1008-1012
Heading: Surgery Article type: Original article
Authors: Kalmin O.V., Nikolsky V.I., Fiodorova M.G., Titova Ye.V., Yangurazova Ye.V.
Organization: Penza State University
Summary:

The purpose: Comparative study of rehabilitation processes after implantation of synthetic and biological materials into the tissue of abdominal wall. Materials and Methods: Histological methods have been used to study tissue samples from 15 implantation area of xenopericardial plate and polypropylene net of adult rabbits in 3, 6 and 12 months after the surgery. Results: It has been found out that polypropylene net implantation in the tissue of anterior abdominal wall causes inflammation and growth of connective tissue only around it. Xenopericardial plate implantation is accompanied by lesser inflammation an3 it connects with surrounding connective tissue. Conclusion: It has been revealed that xenopericardium is more likely to use in herniologythan synthetic net. It provides greater mechanical strength of abdominal wall in the later periods after the surgical intervention.

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Postoperative monitoring of prostate-specific antigen (PSA) after treatment with high-intensive focused ultrasound (HIFU

Year: 2012, volume 8 Issue: №4 Pages: 1001-1007
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Blyumberg B.I.
Organization: Saratov State Medical University
Summary:

Research objective: to estimate efficiency of treatment of prostate cancer using high-intensive focused ultrasound on the basis of laboratory analysis of postoperative level prostate-specific antigen (PSA). Objects of research. Objects of research consisted of 110 patients treated in urological clinic of Hospital n.a. S. R. Mirotvortsev (Saratov State Medical University) during the period February, 2009 — March, 2012. Patients took 110 sessions of primary operative treatment of prostate cancer by HIFU therapy method. Technique and research methods. Concentration of PSA in blood changed in all patients every 1,5 month within 6 months after operation, irrespective of its kind (including after repeated HIFU), further — after every 3 month till one year, and later on after 6 months. We were guided by references of the International Consensus, which considers PSA level more than 0,5 ng/ml in blood after 3 months of treatment to be unsatisfactory result. We also headed for PSA level before treatment and oncological risk degree. Results. Median nadir formed 0,5 ng/ml PSA by 3 months after treatment. Patients demonstrated different indicators of PSA dynamics depending on oncological risk, stage and hormonal therapy management. Patients with low oncological risk had initially lower PSA concentration, further PSA concentration reached nadir level faster. At patients with widespread forms of prostate cancer accurate dependence of PSA concentration according to prevalence of process was traced. Time of PSA nadir amount did not differ and was marked as 12-14 weeks on average. At patients received hormonal therapy, lower value of PSA nadir was marked. The conclusion. Monitoring of PSA concentration (PSA nadir by 3 months, dynamics of PSA concentration change) is of great importance in early revealing of relapse after prostate HIFU therapy. High level of PSA nadir and PSA growth according to time period are important prognostic factors.

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The diagnostic value of biomarkers of inflammation, angiogenesis and fibrogenesis to assess the severity of urodynamic obstruction in children with congenital megaureter

Year: 2012, volume 8 Issue: №4 Pages: 996-1001
Heading: Urology Article type: Original article
Authors: Morozov D.A., Krasnova E.I., Deryugina LA., Zakharova N.B., H'icheva Yu.A.
Organization: Saratov State Medical University, Clinical hospital n.a. S. R. Mirotvortsev SSMU, Moscow Research Institute of Pediatrics and Pediatric Surgery
Summary:

The aim of the study is to determine the diagnostic value of urine biomarkers of inflammation (interleukin-1p, tumor necrosis factor-a), angiogenesis (vascular endothelial growth factor) and fibrogenesis (monocyte chemoattractant protein-1, matrix metalloproteinase-9) to assess the severity of urodynamic obstruction of the ureter. Materials and Methods — Complex investigation of 47 children with congenital nonrefluxing megaureter at the age from 1 month till 11 years is carried. Results. The correlation between the urine level of IL-1p and main laboratory criteria of inflammation occurred, so IL-1p as an integrative indicator of pyelonephritis activity was appeared. The relation between levels of VEGF and MCP-1 and indicators of renal hemodynamics allowed to consider increased levels of these factors as markers of irreversible nephrosclerosis. The urine level of MMP-9 was strongly correlated with parameters of peristalyic activity of the ureter. The group of children with lower peristalyic activity of the megaureter was significantly different from group with normal ureteral peristalsis by the high urine level of MMP-9. We do not have reliable data about the diagnostic value of determination of the urine level of TNF-a in children with congenital megaureter. Conclusion: The urine level of biological markers investigations are very important for clinical practice for determination of pyelonephritis activity (IL-1p), severity of ischemic deterioration of renal parenchyma (VEGF, MCP-1). Further studies are needed to clarify the pathogenic role of MMP-9 in the regulation of peristalyic activity of the ureter during embryonic and postnatal development in patients with congenital nonrefluxing megaureter.

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High intensity focused ultrasound (HIFU) as the alternative method of treatment of oncourological diseases

Year: 2012, volume 8 Issue: №4 Pages: 989-995
Heading: Urology Article type: Review
Authors: Popkov V.M., Fomkin R.N., Blyumberg B.I.
Organization: Saratov State Medical University
Summary:

Increasing interest devoted to technology of high intensity focused ultrasound (high-intensity focused ultrasound, HIFU), basically, is explained by a wide spectrum of potential fields of application at minimum invasiveness of the given method. In oncourology HIFU is applied in prostate and kidney cancer. In case of tumors of renal parenchyma the given technique is being clinically tested, while HIFU is currently used in the practice of European oncourologists in treatment of prostate cancer. The majority of the references describing the results of HIFU application in prostate cancer is based on data of a number of clinical observations. It has been proved that HIFU is a possible method of treatment of highly — and moderate-differentiated tumors, and local relapses after remote radial therapy.

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Modern techniques in treatment of chest and extremity polytraumas

Year: 2012, volume 8 Issue: №4 Pages: 982-988
Heading: Traumatology and Orthopedics Article type: Review
Authors: Khmara A.D., Norkin I.A., Khmara Т.G.
Organization: Saratov State Medical University
Summary:

The article presents a review of Russian and foreign literature on polytrauma. It touches upon the following points: statistic data of the pathology occurrence, mortality and disability from injuries, classification and methods of diagnostics and treatment of multiple traumas and polytraumas.

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Surgical treatment in cases of rare and iatrogenic orthopaedical diseases

Year: 2012, volume 8 Issue: №4 Pages: 979-982
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Yezhov M.Y., Batalov O.A.
Organization: Nizhniy Novgorod Scientific Research Institute of Traumatology and Orthopaedy
Summary:

The aim of the article was to determine symptoms and surgical management for patients in cases of the rare and iatrogenic orthopaedical diseases. Methods. The article concerns Erb-Duchen disease, iatrogenic hallux varus, gout arthropathy of the 1st MTP, spastic supinated foot after astrocytomectomy of the brain, bilateral Haglund disease. Authors describe all symptoms of these rare diseases. Results. There were determined reasons for external apparatuses for lower extremity correction. Accurate preoperative planning allowed to perform effective surgery for patients with rare and hard orthopaedic pathology.

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