Saratov JOURNAL of Medical and Scientific Research

Popkov V.M.

Saratov State Medical University n.a. V.I. Razumovsky, Department of Urology, Assistant Professor, Candidate of Medical Science

Prognostic significance of the assessment of the expression of immunohistochemical markers and the degree of pathomorphism before and after treatment of patients with prostate cancer at high risk of progression

Year: 2019, volume 15 Issue: №2 Pages: 318-324
Heading: Urology Article type: Original article
Authors: Voronina E.S. , Fomkin R.N. , Bucharskaya A.B. , Palatova T.V. , Popkov V.M., Maslyakova G.N.
Organization: Saratov State Medical University
Summary:

Purpose: to analyze the expression of immunohistochemical markers in patients with prostate adenocarcinoma at high risk of progression before and after combined and combined treatment of patients with prostate specific antigen (PSA) level of blood below discriminatory. Material and methods. Examined patients (n = 80) with a diagnosis of “High-risk progression prostate cancer,” with clinical stage T3a, total score for Gleason scale from 8 to 10, the level of total PSA more than 20 ng / ml. Patients of the 1st group (n = 42) only combined surgical treatment in the scope of TUR and HIFU ablation the prostate; The 2nd group of patients (n = 38) additionally applied androgen deprivation in adjuvant mode. Results. Blood PSA, determined in patients after various methods of treatment is not always an objective indicator of its effectiveness. Immunohistochemical studies of tumor tissue for proliferative activity tumor cells, the activation of apoptosis in them, as well as the assessment of specific tumor markers and tumor suppressor genes showed that a decrease in the expression of these markers in patients with PSA values ​​of blood lower than discriminatory observed in all patients independently on the type of treatment. However, after treatment in the 1st group of patients, despite the achievement PSA level of nadir, there is a decrease in the expression of an intercellular adhesion marker E-cadherin, which indicates an increased risk of tumor metastasis, as well as increased expression of markers of the apoptosis inhibitor Bcl-2 and androgens, which indicates about the possibility of progression of tumor growth. Conclusion For a more accurate assessment therapeutic pathomorphism in patients with prostate cancer at high risk of progression, which HIFU ablation monotherapy was carried out, along with the determination of blood PSA level, it is necessary during the control biopsy of the prostate immunohistochemical studies of tumor tissue to determine the prognosis and risk of relapse.

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Biomarkers of renal damage and immunohistochemical detection of oncogenesis in the surgical treatment of renal cell carcinoma

Year: 2018, volume 14 Issue: №3 Pages: 420-426
Heading: Urology Article type: Original article
Authors: Tarasenko A.l., Rossolovsky A.N., Berezinets O.L., Ponukalin A.N., Medvedeva A.M., Zakharova N.B., Popkov V.M., Maslyakova G.N.
Organization: Saratov State Medical University, I.M. Sechenov First Moscow State Medical University
Summary:

Objective: to assess the possibility of using markers of renal injury and carcinogenesis as additional criteria for the choice of the method of surgical treatment of RCC and to minimize the risk of development and progression of kidney injury. Material and Methods. 60 patients with morphologically confirmed RCC T1-3M0N0 operated on in the volume of open nephrectomy or laparoscopic nephrectomy or laparoscopic resection and the kidney were examined. Patients were divided into 3 groups: group 1: patients after nephrectomy performed for kidney cancer using traditional surgical technique, group 2: patients after laparoscopic nephrectomy and group 3: after laparoscopic resection of kidney tumor. Before surgical operation, on the 5-7 day and after 1 month, all patients were examined by concentrations of urinary excreted lipocalin 2 (NGAL), and serum concentrations of IL-18, MMP-9 and IGF-1. Renal function was estimated using the calculated GFR equation (CKD-EPI 2009) based on serum creatinine level. Immunohistochemical study of histological preparations of distant tumors on proliferation antibodies (Ki-67, PCNA), apoptosis (BAX, Bcl-2) was performed. Differences in clinical data and clinical variables were compared using Spearman rank correlations and t-test. Results. The studied indices of renal damage of IL-18, NGAL, MMP-9 and IGF-1 both in the early (5-7 days) and later (1 month) postoperative period showed a correlation between the surgical intervention method and the degree of tumor cell differentiation. Conclusion. The levels of biomolecular markers of renal damage (IL-18, NGAL, MMP-9 and IGF-1) correlate with the degree of differentiation in thetumoral cells and functional activity of the remaining renal parenchyma in the postoperative period, but also depend on the individual characteristics of the patient's body. A certain level of expression of MMP-9 and IL-18 with a small tumor size can be a guide to determine the indications for the choice of organ-preserving surgery in patients.

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Endoscopic correction of obstructive complications after HIFU-ablation of the prostate with holmium laser

Year: 2018, volume 14 Issue: №2 Pages: 272-277
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Shatylko T.V.
Organization: Saratov State Medical University
Summary:

Purpose: to improve the results of treatment of the obstructive complications (an urethra stenosis, a bladder neck sclerosis) caused by application of the high-intensity focused ultrasonic ablation (HIFU) concerning treatment of the localized prostate cancer. Material and Methods. An object of the research included 41 patients, with the infravesical obstruction (IVO) which has arisen in the postoperative period to which elimination the holmium laser is used. Results. The bladder neck was the most frequent place of obstruction. Average time before emergence of the first episode of IVO: 8.2±1.3 months. Distinctions on time before development of an episode of IVO depending on the fact of carrying out TURP before HIFU not confirmed (p=0.440). More advanced age for a moment HIFU-ablation has been associated with much higher frequency of IVO (p=0.021). Considerably smaller frequency repeated was observed by IVO at a larger ratio transurethral resection to the initial volume of a prostate (p=0.031). Duration of a laser endoscopic ure-throtomy was 27 [10-70] minutes, serious perioperative or postoperative complications were not determined. Average term before removal of a catheter of Foley: 3 [1-5] days, hospitalization duration included 4 [3-6] days. After treatment considerable improvement on indicators of the maximum speed of a stream of urine (Qmax) and volume of residual urine was observed. The total score according to the questionnaires of IPSS and QoL has considerably improved, significant changes on symptoms of accumulation are noted. After the first holmium laser urethrotomy of 80.4% of patients have noted satisfactory results without recurrence of IVO; 19.6% of patients were required a repeated laser endoscopic urethrotomy. Recurrence term after the first laser urethrotomy is on average equal to 2.5 months. Conclusion. The endoscopic urethrotomy by means of the holmium laser is safe, effective and minimum invasive type of treatment of a stenosis of a neck of the bladder / urethra after ablative cancer therapy of prostate. The advantages are the minimum of traumas of surrounding tissues and preservation of the mechanism of deduction of urine.

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Youth policy at Medical University in conceptual and practical realization

Year: 2018, volume 14 Issue: №1 Pages: 100-106
Heading: Pedagogics and Education Article type: Author's opinion
Authors: Popkov V.M., Bugaeva I.O., Zhivaykina А.А., Loyko V.S., Andriyanova E.A.
Organization: Saratov State Medical University
Summary:

The aim of the article is to consider the main theoretical and practical aspects of implementation the program of youth policy in the Saratov State Medical University n.a. V. I. Razumovsky. Authors analyze the educational system and the way it correlates to modern challenges of the Russian society. Special attention is paid to the main conditions of realization and the directions of youth policy in the Saratov State Medical University. The conceptual principles of youth policy of higher school have been worked out by the authors.

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Psychological predictors of reproductive attitudes among medical students

Year: 2017, volume 13 Issue: №3 Pages: 549-553
Heading: Sociology of Medicine Article type: Original article
Authors: Popkov V.M., Bugaeva I.O., Andriyanova Е.А., Aranovich I.Yu., Katkova A.V., Chernyshkova E.V., Aranovich L.M.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

The goal was to determine psychological predictors of reproductive attitudes among medical students. Material and Methods. The survey of 84 students (of the 3rd and the 5th year of medical faculty of Saratov State Medical University n.a. V. I. Razumovsky) was carried out using a combination of methods (questionnaire, testing) aimed to achieve the research goal. Results. Features of reproductive attitudes and reproductive intentions of students, as well as psychological characteristics of youth, such as personal maturity, belief in people and value orientations were studied. Psy- chological predictors of reproductive attitudes among medical students were determined. Conclusion. It was revealed that reproductive attitudes among students of the 5th year were higher than those of the 3rd year. There were gender differences in psychological predictors of reproductive attitudes among students. It was experimentally established that existence of faith in people, high level of personal maturity, high importance of personal values, altruistic values and values of acceptance of others had a positive impact on reproductive attitudes among young people. Based on the results of the study, recommendations were developed with the aim to improve reproductive attitudes and psychological readiness for parenting of medical students.

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Physiotherapeutic methods in treating patients with chronic abacterial prostatitis / chronic pelvic pain syndrome: current and development perspectives

Year: 2017, volume 13 Issue: №3 Pages: 532-536
Heading: Urology Article type: Review
Authors: Popkov V.M., Churakov А.А., Dolgov А.В., Rossolovsky A.N., Spirin P.V.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

Chronic abacterial prostatitis / chronic pelvic pain syndrome is one of the most common diseases in urological practice. Physical factors are widely used in treatment of this pathology. This literature review is devoted to study of role of physiotherapeutic methods in treatment of chronic abacterial prostatitis and prospects for development of this therapeutic direction.

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Dynamics of angiogenesis and inflammation biomarkers in patients with urolithic disease with obstructive uropathy

Year: 2017, volume 13 Issue: №3 Pages:
Heading: Urology Article type: Original article
Authors: Popkov V.M., Zakharova N.B., Ponukalin A.N., Polozov A.B., Khotko D.N., Khotko A.l., Spirin P.V.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

Purpose: to establish the nature of changes in markers of angiogenesis and inflammation in the blood serum and urine in patients with obstruction of the ureteropelvic segment or upper third of the ureter by ureteral stones in different terms of the kidney drainage. Material and Methods. 53 patients with urolithiasis have been examined. The main group consisted of 33 patients with concrements of the upper third of the ureter or renal pelvis-ureteral segment with pres- ent obstructive uropathy. The comparison group consisted of 20 patients with calculi of the kidney without symptoms of obstruction. In the main group patients underwent drainage of the kidney by percutaneous-nephrostomy puncture. Results. Patients of the main group revealed a significant increase in the levels of markers of angiogenesis and inflammation before the kidney drainage. The level of MCP-1 correlated with the level of serum creatinine. In the process of drainage the levels of these markers were decreased as a result of increased GFR. Determination of the concentration of urinary VEGF, IL-8 and MCP-1 in patients may have clinical value in personalized management of patients with obstructive uropathy to determine the optimal terms of the second stage of the surgical intervention. Conclusion. Determination of markers of inflammation and angiogenesis in the urine of patients in conjunction with assessment of renal function by creatinine level is important for determining the term of kidney drainage.

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Portrait of V.I. Razumovsky: to the 160th anniversary of the birth of the first rector of Saratov State Medical University

Year: 2017, volume 13 Issue: №2 Pages: 309-313
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Popkov V.M., Kochetkova T.V., Chernenkov Yu.V., Bugaeva I.O., Yerugina M.V.
Organization: Saratov State Medical University
Summary:

Saratov Journal of Medical Scientific Research 2017; 13 (2): 309-313. The article is devoted to the role of professor V. I. Razumovsky in the development of Saratov University and the development of medical science in the Saratov province.

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The influence of premorbid background on the course of urolithiasis

Year: 2017, volume 13 Issue: №2 Pages: 280-283
Heading: Urology Article type: Original article
Authors: Osnovin O.V., Popkov V.M., Fomkina O.A.
Organization: Saratov State Medical University
Summary:

Aim: to analyze the correlation between the unfavorable factors at newborn patients and children and the peculiarities of the course of urolithiasis in adults. Material and Methods. The data were received from questioning of 286 patients and their relatives, analysis of case histories and past medical histories. The material was statistically worked out. Results. The early development of urolithiasis (at patients under 30) was associated with the threat of termination of pregnancy, prematurity, excretory and digestive disorders at childhood in case of severe anamnesis of urolithiasis, and also malnutrition. Bilateral lesions of the urinary system were determined to be associated with artificial feeding and prematurity, digestive diseases and complicated anamnesis of urolithiasis, malnutrition, deprived living conditions and low income. Stones in calyces occurred at patients with different complications at birth. More frequent cases of stone formation in renal pelvis were observed at premature and malnutrition patients and patients with cardiovascular diseases occurred during the childhood. Stones in ureters were considered as a result of respiratory diseases effect. Conclusion. Unfavorable factors occurred at birth and childhood, factors concerned with deprived social conditions and psychological problems influence the onset and the course of urolithiasis.

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Children's rights when receiving medical care in the Russian Federation

Year: 2017, volume 13 Issue: №2 Pages: 205-208
Heading: Health Service Organization Article type: Review
Authors: Popkov VM, Erugina MV, Vlasova MV, Dolgova EM, Timofeev DA, Abyzova NV, Chernyak MD
Organization: Centre of Medical-Sociological Research, Saratov State Medical University
Summary:

The article presents the legal provisions containing the rights of children and duties of medical workers in providing medical care to children in the Russian Federation. It is shown that these legal provisions set out in the relevant legislative documents do not exist in isolation, but in conjunction with other legal norms, which complicates the possibility of their implementation by medical workers in full. It is stated that special responsibility and the cost of failure in modern conditions require medical staff to use not only professional knowledge, but also legal aspects accompanying their work. This suggests the need to focus attention to the learning process of students and listeners of faculties of improvement of professional skills and professional retraining of specialists of universities on peculiarities of realization of children's rights in providing them medical care.

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