Saratov JOURNAL of Medical and Scientific Research

Blumberg B.I.

Saratov State Medical University n. a. V. I. Razumovsky, Scientific Research Institute of Fundamental and Clinical Uronephrology, Department of Urology, Senior Research Assistant of Reconstructive Uronephrology and Kidney Transplantation Department, Assistant Professo, Candidate of Medical Science

Experience of terahertz therapy in benign prostatic hyperplasia combined with chronic abacterial prostatitis

Year: 2014, volume 10 Issue: №4 Pages: 649-654
Heading: Urology Article type: Original article
Authors: Popkov V.M., Kirichuk V.F., Loyko V.S., Maslyakova G.N., Blyumberg B.l.
Organization: Saratov State Medical University
Summary:

Objective: to improve the treatment results of patients with benign prostatic hyperplasia (stage l-ll) accompanied with chronic abacterial prostatitis (category III A) by the use of terahertz therapy at frequencies of molecular spectrum of emission and absorption of nitric oxide 150,176-150,664 GHz. Material and methods. Atotal number of 75 patients met the inclusion criteria and were available for analysis. They were divided into three groups: 1st core group — 25 patients with BPH (stage l-ll) accompanied with chronic abacterial prostatitis (category III), which received standard medical therapy in combination with THZ-therapy; second group — 25 patients with BPH (stage l-ll) accompanied with CAP, which received standard medical therapy; third control group — 25 healthy men. Results. The combination of THZ — therapy with standard medical treatment allowed us to achieve marked improvements in the IPSS and QoL system, rapid anesthetic effect, more significant volume reduction of the prostate tissue in the 1st core group. Also THZ-therapy in 1st core group revealed a statistically significant increase of the maximum speed of blood vessels in the prostate tissue, improved a prostate secretion and rheological properties of blood. Conclusion. THZ-therapy as a complementary treatment has a beneficial effect on the clinical course of BPH (stage l-ll) accompanied with CAP (category III).

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Combination of the transurethral resection and prostate HIFU ablation at treatment of the localized cancer

Year: 2014, volume 10 Issue: №3 Pages: 450-455
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Blyumberg B.l., Shatylko T.V., Sedova L.N., Abramova E.P.
Organization: Saratov State Medical University
Summary:

Research objective: to estimate results of treatment of patients with the localized form of a cancer of a prostate at a combination of a transurethral resection (TURP) and HIFU of an ablation. Objects and research methods: From February, 2009 to February, 2014 of 100 patients with the localized form of a cancer of a prostate were selected for research:
26 patients were included into HIFU and 74 group in group of the combined treatment (TURP+HIFU). Selection criteria for HIFU ablation were the localized cancer of a prostate concerning which earlier it wasn't carried out treatments, and level of a PSA at the time of statement of the diagnosis 15 ng/ml. All patients corresponding to these by criteria, were considered as candidates for treatment and inclusion in the analysis. The nadir and stability of PSA, the histologic conclusion, IPSS, quality of life and complication were estimated at time of postoperative supervision. Results: Statistically significant influence of a combination TURP+HIFU for the term of transurethral drainage of a bladder (a median of 40 days against 7 days), incontience frequency (15.4% against 6.9%), infections of urinary ways (47.9% against 11.4%) and IPSS change during the postoperative period (on the average 8.91 against 3.37) is noted. During the short period of supervision it wasn't observed considerable changes in relation to efficiency: in HIFU group the frequency of repeated sessions made 25%, in TUR/HIFU group 4%. Conclusion: HIFU therapy is modern, minimum invasive method of a cancer therapy of a prostate. The combination of a transurethral resection and HIFU ablation significantly reduces the frequency of the complications connected with treatment. Maintaining the patient after combined TURP and HIFU ablation is comparable with maintaining the patient after usual TURP.

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Возможности прогнозирования рецидива рака простаты после HIFU-аблации с помощью математического моделирования

Year: 2013, volume 9 Issue: №2 Pages: 314-320
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Blumberg B.I.
Organization: Saratov State Medical University
Summary:

Research objective: Creation of mathematical prognosis of model of local relapsing tumors in patients with prostate cancer after treatment by high-intensive focused ultrasound (HIFU). Objects and Research Methods: Results of treatment are estimated at 102 patients with morphologically localized prostate cancer proved at biopsy. For the purpose to analyze interrelation of prognostic factors and postoperative morphological research of prostate control biopsies after HIFU ablation with frequent development of relapses comparative statistical research of received data has been conducted. For construction of mathematical models of relapse prognosis after HIFU of prostates two methods of mul-tifactorial analysis of the data have been used: the discriminant analysis and logistical regress. Results: While planning treatment of patients after HIFU ablation of prostates it has been necessary to estimate morphological risk factors of local relapse of a neoplasm such as preoperative level of serum PSA, the sum of Gleason, severity of disease, presence of lymphovascular and perineural invasion. The offered formulas are worth while using in revealing of probability of development of relapses. The comparative analysis of mathematical models has showed that accuracy of prognosis of results of HIFU of prostates is high enough.

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Improvement of complex therapy of patients with pathology of scrotal organs formed by chronic brucellosis infection

Year: 2013, volume 9 Issue: №2 Pages: 165-170
Heading: Infectious Diseases Article type: Original article
Authors: Glybochko Р. V., Evdokimov A.M., Liapina Е.Р., Shuldiakov A. A., Ponukalin A.N., Blyumberg В.I., Sedova L.N.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

The aim of the study is to improve the treatment of patients with male reproductive organs pathology, formed by chronic brucellosis infection. Material and methods: We have analyzed the dynamics of the clinical manifestations of diseases of the scrotal organs, data of physical and ultrasound studies, semen parameters, the quality of life in 22 patients with chronic brucellosis and the presence of orchitis / orchiepididymitis against conventional therapy (10 patients), and combined treatment with the inclusion of cycloferon (i/m, 2 injection rate from 5 (0.25g) with a break 10 days) — 12. Results: We have proved ability of cycloferon to reduce the severity of the inflammatory process in the testis and epididymis, with improving of spermatogenesis and the quality of life for patients. We have marked the reduction in the number of exacerbations of chronic orchitis / orchiepididymitis 2.4 times after the course of cycloferon, its good tolerability of patients, no side effects. Conclusion: Using these results, the presence of anti-inflammatory and immunomodulatory potencies, cycloferon can be recommended in treatment of inflammatory lesions of the scrotal organs in patients with chronic brucellosis.

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Prognostic factors in the estimation of HIFU treatment efficiency in patients with localized prostate cancer

Year: 2013, volume 9 Issue: №1 Pages: 116-121
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 study the role of prognostic factors in the estimation of risk development of recurrent prostate cancer after treatment by high-intensive focused ultrasound (HIUF). Objects and Research Methods: The research has included 102 patients with morphologically revealed localized prostate cancer by biopsy. They have been on treatment in Clinic of Urology of the Saratov Clinical Hospital n.a. S. R. Mirotvortsev. 102 sessions of initial operative treatment of prostate cancer by the method of HIFU have been performed. The general group of patients (n=102) has been subdivided by the method of casual distribution into two samples: group of patients with absent recurrent tumor and group of patients with the revealed recurrent tumor, by morphological research of biopsy material of residual prostate tissue after HIFU. The computer program has been used to study the signs of outcome of patients with prostate cancer. Results: Risk of development of recurrent prostate cancer has grown with the PSA level raise and its density. The index of positive biopsy columns

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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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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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The differential approach to estimation of renal damage in the patients with nephrolithiasis by means of noninva-sive markers

Year: 2010, volume 6 Issue: №3 Pages: 708-715
Heading: Urology Article type: Original article
Authors: Rossolovsky A.N., Glybochko P.M., Popkov V.M., Polozov A.B., Ponukalin A.N., Zakharova N.B., Berezinetz O.L., Blumberg B.I.
Organization: Saratov State Medical University, Saratov State Cardiosurgical Centre, First Moscow State Medical University n.a. I.M. Sechenov
Summary:

The aim of this study was the estimation of clinical importance markers of renal damage at surgical treatment of nephrolithiasis. We studied results of operations in 110 patients with nephrolithiasis. The study presents new candidates for biochemical markers of acute kidney injury and renal interstitial fibrosis, with potentially high sensitivity and specificity. In this study were measured the concentrations of these biomarkers in urine. We suggested, that increased concentrations molecular mediators of renal damage (L2, IL-18) and interstitial fibrosis (MCP-1, TGFp, IGF1) in the patients with nephrophibrosis and strongetubulointerstitial injury, saved long-time period after operation, has been shown of progression chronic kidney disease

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