Saratov JOURNAL of Medical and Scientific Research

№1, 2010, volume 6

Scientific school of professor L.S. Schwarz during the years of the Great Patriotic War

Year: 2010, volume 6 Issue: №1 Pages: 209-210
Heading: History of Medicine. Anniversary Dates Article type: Short message
Authors: L.S. Yudanova
Organization: Saratov State Medical University
Summary:

The article presents the history of scientific school of professor L.S. Schwarz during the years of the Great patriotic war

Keywords: therapeutical department, scientific school

Educational process organisation in internship of internal diseases

Year: 2010, volume 6 Issue: №1 Pages: 206-208
Heading: Pedagogics and Education Article type: Short message
Authors: A.A. Svistunov, A.A. Protopopov, A.P. Rebrov, E.Yu. Ponomareva, E.V. Voloshinova
Organization: Saratov State Medical University
Summary:

The article gives close attention to the experience of Department of Hospital Therapy concerned with the organisation of the first step post-diploma education of interns who are trained at the Clinical Department of Internal Diseases

Keywords: residency, post-diploma medical education, internal diseases

Paroxysmal conditions of nonepileptic genesis

Year: 2010, volume 6 Issue: №1 Pages: 199-205
Heading: Practice physician Article type: Review
Authors: A.Y. Karas, L.A. Kabanova, L.Y. Glukhova
Organization: Saratov State Medical University, Russian State Medical University
Summary:

Пароксизмальные состояния могут наблюдаться и при эпилепсии и при других заболеваниях. Наиболее частыми пароксизмальными состояниями, ошибочно принимаемыми за эпилепсию, являются синкопы, конверсионные или псевдоэпилептические приступы, парасомнии, пароксизмальный хореоатетоз, доброкачественные миоклонии. Неправильный диагноз эпилепсии, особенно в детстве, будет влиять на развитие ребенка, его качество жизни. Подробный анамнез - краеугольный камень в постановке диагноза. Окончательный диагноз будет зависеть от опыта и умения врача анализировать имеющуюся информацию. Золотым стандартом диагностики трудных и фармакорезистентных пациентов является видео-ЭЭГ-мониторинг

Keywords: video-EEG-monitoring, syncopes, sleep phenomena, pseudoseizures, benign myoclonia

Noninvasive method of blood viscosity and hematocrit monitoring

Year: 2010, volume 6 Issue: №1 Pages: 194-198
Heading: Surgery Article type: Original article
Authors: O.A. Tsarev, F.G. Prokin, Ju.V. Mashchenko, A.I. Nabegaev, V.V. Dubanosov, A.M. Imangulov, S.A. Zyazyanov
Organization: Saratov State Medical University
Summary:

Research objective is to study substantiation of noninvasive method of blood viscosity and hematocrit monitoring. it contains the results of theoretical, experimental and clinical studies held to examine the mechanism of pulse wave distribution. The interrelation between pulse wave parameters, pulse wave velocity, systolic and diastolic blood pressure, blood viscosity and hematocrit has been revealed. Noninvasive method of blood viscosity and hematocrit determination has been worked out. it is distinguished by the following factors: pulse wave of the main artery registered at two limb levels, the amplitude of pulse wave, the duration of its trailing edge and the time of pulse wave distribution. Systolic and diastolic blood pressure are recorded. Blood viscosity and hematocrit calculations are made by means of mathematical treatment with the help of original program. the device for noninvasive blood viscosity and hematocrit monitoring has been created on the basis of elaborated method. Data precision obtained by noninvasive measurement of hematocrit and blood viscosity does not exceed 3%.
the clinical use of noninvasive method enables to approach the problem of atherosclerosis prevention, to improve the results of atherosclerosis treatment and to look at it from critically new noninvasive positions

Keywords: pulse wave, noninvasiveness, hematocrit, blood viscosity

Complex treatment of patients with malignant cerebral gliomas of supratentorial localization: follow -up results

Year: 2010, volume 6 Issue: №1 Pages: 189-194
Heading: Surgery Article type: Original article
Authors: S.P. Bazhanov
Organization: Saint-Petersburg Scientific Research Institute of Neurosurgery n.a. A.L. Polenov
Summary:

The aim of the research is to investigate specific antitumor immunotherapy on the basis of autologous dendritic cells in the complex treatment of patients with malignant cerebral gliomas of supratentorial localization. 55 patients with malignant gliomas (41 with glioblastomas, 14 with anaplastic astrocytomas) have been analysed who had received complex treatment with specific immunotherapy. All the patients were hospitalized at complicated disease stages and with tumors over 5 cm in diameter. Specific antitumor immunotherapy was conducted according to the original methodology and included autologous dendritic cells with tumor antigens and tumor cells lysate. Treatment course consisted of autologous dendritic cells introduction on the 10-12th day after the operation. It was performed every 2-3 months. Follow-up results of specific antitumor immunotherapy with autologous dendritic cells were analised. It was noted that lifetime of patients with malignant supratentorial gliomas became longer in comparison with average statistical results. In conclusion it is of importance to point out that specific antitumor immunotherapy included into complex treatment of malignant gliomas allowing to increase disease remission and quality of life

Keywords: immunotherapy, glioblastoma, dendritic cells, anaplastic astrocytoma

Comparative analysis of perioperative period in children with different corrections of vesicoureteral reflux

Year: 2010, volume 6 Issue: №1 Pages: 182-188
Heading: Urology Article type: Original article
Authors: P.V. Glybochko, A.A. Svistunov, O.L. Morozova, D.A. Morozov, B.V. Dolgov, F.K. Napolnikov
Organization: Saratov State Medical University
Summary:

The article presents the analysis of perioperative period of 52 children with different variants of correction of vesicoureteral reflux. It was based on acute-phase proteins amount, cytokines level and adhesion molecules content in blood and urine. the study revealed that if the correction is performed during the latent phase of chronic obstructive pyelonephritis the preference should be given to the endoscopic operations as they do not lead to acute inflammatory process in the urinary tract

Keywords: vesicoureteral reflux, cytokines, children, adhesion molecules, acute-phase proteins

Criteria of Clinical Diagnostics and Choice of Treatment Strategy in Children with Disoders of Sexual Development

Year: 2010, volume 6 Issue: №1 Pages: 178-182
Heading: Urology Article type: Original article
Authors: N.V. Bolotova, D.A. Morozov, N.U. Raygorodskaya, D.A. Zharkov, M.M. Grigorjeva, E.N. Tsmokalyuk
Organization: Saratov State Medical University
Summary:

The number of patients with disorders of sexual development (DSD) has increased in 3.54 times during the last three years. The aim is to define the structure of intersexual disorders in children from Saratov, criteria of gender assignment and surgical approach. During the period of three years (from 2006 till 2008) 58 children with DSD aged 0 - 17 were examined. Assessment of external genitals, cytogenetic investigation, hormonal tests were performed. Imaging studies included ultrasonography, cystourethroscopy and laparoscopy with histological investigation. Considering the data DSD in children from Saratov compose sex chromosome DSD - 21,4 %, Gonadal dysgenesis - 26,2%, ovotesticular DSD - 2,3%, 46,ХХ testicular DSD - 2,3 %, complete androgen insensitivity syndrome - 4,7%. The criteria of gender assignment and surgical approach have been described in the article. The research concludes that the infants with intersexual genitels should be examined in special care centers by multispecialty team. It is nessesary to perform the karyotype test and ultrasonic study in newborns to detect the genetic and gonadal gender of the child

Keywords: sex chromosome, gonadal dysgenesis, disorders of sexual development

The prenatal verification of the obstructive uropathy at the fetal

Year: 2010, volume 6 Issue: №1 Pages: 173-178
Heading: Urology Article type: Original article
Authors: M.L. Chekhonatskaya, P.V. Glybochko, N.U. Arenina, L.V. Piskunova, M.M. Grigorieva
Organization: Saratov State Medical University, Saratov Clinical Hospital №3
Summary:

The research goal is to study functional condition of upper and lower urinary tracts at fetus with obstructive uropathy and development of differential diagnostic and prognostic criteria of transition of functional disorders to organic.
The diagnosis of prenatal and verified postnatal obstructive uropathy at 42 fetuses has been made by prenatal ultrasonic cystometry. Process of filling and evacuation of bladder has been under study. Obtained data have been compared with the results of dynamic measurement of kidney sizes in a standard projection.
According to the results only at 19,1% of cases statistically significant urodynamic differences have not been revealed in comparison with control group. Diagnostic accuracy of organic form of urodynamic obstructions is 84%, of functional in 64,7% of observations and in 52,9% of cases the infection of urinary tracts with incomplete evacuation of bladder has been diagnosed.
The degree of kidney and ureter expansion is not a differential diagnostic criterion of organic or functional urodynamic obstructions. However, using a principle of estimation of upper and lower urinary tracts condition, it is possible to make a prenatal differential diagnosis of variants of defects

Keywords: urinary bladder, obstructive uropathy, newborn, fetus

State of renal hemodynamics and nephrofibrosis parameters in patients with nephrolithiasis applying angiotensin converting enzyme inhibitors

Year: 2010, volume 6 Issue: №1 Pages: 170-173
Heading: Urology Article type: Original article
Authors: P.V. Glybochko, A.A. Svistunov, A.N. Rossolovsky, O.L. Berezinetz, N.B. Zakharova, A.P. Abramova
Organization: Saratov State Medical University, Saratov State Cardiosurgical Centre
Summary:

The aim of the study is to evaluate the influence of angiotensin converting enzyme (ACE) inhibitors of quinapril on the condition of renal hemodynamics, changes of profibrotic cytokines level and transforming growth factor at patients with nephrolithiasis undergone various kinds of surgery. Patients were divided into 2 groups initially and in 1 month after surgery. Concentrations of IL-6, TGFp and МСР-1 were determined in blood serum. Assessment of renal blood flow state by Doppler ultrasonography was performed in the same terms. As a result of quinapril treatment the decrease of МСР-1, TGFp and IL-6 was marked in comparison with the group which did not receive nephroprotective therapy. The analysis of Doppler ultrasonography data showed authentic improvement of renal blood flow in 1 month after surgery. The most informative parameter proved to be the resistance index that indicated the decrease of vascular resistance after surgical treatment in condition of quinapril therapy

Keywords: renal hemodynamics, profibrotic cytokines, nephrolithiasis, ACE inhibitors

Neuroendocrine aspects of prostate oncogenesis

Year: 2010, volume 6 Issue: №1 Pages: 164-170
Heading: Urology Article type: Review
Authors: P.V. Glybochko, V.M. Popkov
Organization: Saratov State Medical University
Summary:

The prostate cancer is a widespread disease in Russia with high growth rate and high death rate. Active work in discovery of methods of early diagnostics of prostate cancer is carrying out. it will allow to increase considerably the efficiency of treatment. the data on topography, structural and functional organization, physiology and regulatory effect of neuroendocrine cells and neuroendocrine hormones and peptides of prostate produced by neuroendocrine cells are presented in the review. Neuroendocrine mechanisms of development, prospects of early diagnostics and prognosis of prostate cancer are analyzed

Keywords: prostate, pathogenesis, neuroendocrine cells, cancer