scholarly journals Predictive value of MMP-2, MMP-9, TIMP-1 in surgical treatment of localized renal cell cancer

2021 ◽  
Vol 8 (2) ◽  
pp. 62-74
Author(s):  
A. I. Tarasenko ◽  
A. N. Rossolovskiy ◽  
O. L. Berezinets ◽  
D. A. Durnov ◽  
E. B. Popyhova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Blood Serum ◽  
Sensitivity And Specificity ◽  
Postoperative Period ◽  
Radical Nephrectomy ◽  
Solid Phase ◽  
Cell Cancer ◽  
Individual Characteristics ◽  
Dynamic Monitoring ◽  
Design Bureau

Purpose of the study. To determine the association of individual biomolecular markers of oncogenesis MMP‑2, MMP‑9 and the inhibitor of metalloproteinases TIMP‑1 with the risk of tumor invasion and metastasis in the early and late postoperative period in various types of surgical treatment of RCC.Materials and methods. The study prospectively included medical data of 60 patients with kidney cancer with T1-3N0 M0 who received surgical treatment at the Urology Clinic of the S.R.Mirotvortsev Design Bureau of the SSMU from 2016 to 2019. The patients were divided into 3 groups: 1st group included 20 patients who underwent kidney resection for elective indications, with tumors of the renal parenchyma; 2nd group – 20 patients who underwent radical nephrectomy by laparoscopic approach; Group 3-20 patients who underwent radical nephrectomy with lumbotomy access. All patients being in the early (7-10th day) and long-term postoperative period (after 1 and 2 years) by solid-phase ELISA, on a StatFax 4200 analyzer using eBiosence and Cloud-Clone Corp reagent kits, a study was made on the basis of the concentration in the blood serum of markers of oncogenesis MMP‑2, MMP‑9 and TIMP‑1 metalloproteinase inhibitor.Results. In all groups of patients with RCC, an initial increase in the concentration of MMP‑9 was revealed compared to the control (p≤0.05). According to the results of the ROC analysis, this indicator has a high specificity and sensitivity in terms of predicting RCC at the preoperative stage. The highest sensitivity and specificity for detecting tumor progression was demonstrated by matrix metalloproteinases: MMP‑2 – sensitivity 96 %, specificity 67 % (cut-off point 357.5 pg/ml) and MMP‑9 – sensitivity 87.5 % and specificity 62 % (cut-off point 958 ng/ml). At the same time, TIMP‑1 showed less significant indicators – sensitivity and specificity (74 % and 60 %, respectively) with a cut-off point of 0.49 ng/ml.Conclusion. Serum MMP‑2 and MMP‑9 are a marker of a poor prognosis for the progression of RCC. Elevated levels of MMP‑9 in the blood serum of RCC patients before and after various types of surgical treatment reflect the individual characteristics of the patient’s body and the tumor process. Dynamic monitoring of the level of markers of oncogenesis in patients with RCC allows a personalized approach to the choice of the scope and method of surgical treatment of RCC.

scholarly journals Hypopituitarism as a result of recurrent craniopharyngioma

2020 ◽  
Vol 11 (4) ◽  
pp. 74-77
Author(s):  
Z. R. Alimetova ◽  
A. I. Galieva
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Clinical Observation ◽  
Dynamic Monitoring ◽  
Endoscopic Endonasal

The article presents a clinical observation of a patient with a complication of endoscopic endonasal removal of craniopharyngioma in the form of hypopituitarism. The peculiarity of this case is a recurrent course of craniopharyngioma, due to which the patient was twice subjected to surgical treatment. This demonstrates the necessity of dynamic monitoring of the patient in the postoperative period.

scholarly journals The role of cytokines in the pathogenesis of infectious complications in surgical treatment of obstructive jaundice of gallstone origin

2021 ◽  
Vol 20 (3) ◽  
pp. 105-111
Author(s):  
O. V. Smirnova ◽  
N. G. Elmanova
Keyword(s):  
Surgical Treatment ◽  
Obstructive Jaundice ◽  
Blood Serum ◽  
Proinflammatory Cytokines ◽  
Postoperative Period ◽  
Infectious Complications ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
High Concentrations

Aim. To study the content of cytokines in the blood serum of patients with obstructive jaundice of gallstone origin before and after surgical treatment, depending on the development of postoperative complications.Materials and methods. The treatment group consisted of 70 patients with the diagnosis of obstructive jaundice of gallstone origin, verified following a comprehensive clinical and instrumental examination. In 54 patients, the postoperative period was uncomplicated, and in 16 patients, various infectious complications in the postoperative period were revealed. The control group consisted of 125 healthy volunteers. The concentration of six cytokines (interleukin (IL)-2, IL-4, IL-18, IL-10, tumor necrosis factor alpha (TNFα), and interferon gamma (INF γ)) was determined using reagent kits manufactured by Vector-Best LLC (Novosibirsk, Russian Federation) by enzyme-linked immunosorbent assay on the Thermo Scientific analyzer (BioMerieux, France).Results. We identified significantly high concentrations of proinflammatory cytokines in the blood serum of patients with obstructive jaundice of gallstone origin upon admission, compared with the data obtained in the study of blood serum in the control group and in patients with obstructive jaundice after surgery. In the postoperative period in patients with obstructive jaundice without complications, the proinflammatory cytokines are significantly reduced and IL-4 is increased, whereas with the development of infectious complications, the level of proinflammatory cytokines is significantly elevated.Conclusion. In the pathogenesis of obstructive jaundice, a local inflammatory process plays an essential role. This is confirmed by statistically significant changes in the studied cytokines. The established increase in the concentration of IL-4, which has anti-inflammatory activity, indicates its importance in the mechanisms underlying the absence of infectious complications in the postoperative period of obstructive jaundice of gallstone origin. The revealed increase in the levels of IL-18, TNFα, and INFγ in the blood serum of patients suggests their role in the pathogenesis of infectious complications in the postoperative period of obstructive jaundice of gallstone origin.

scholarly journals Management of local recurrence after radical nephrectomy: surgical removal with or without systemic treatment is still the gold standard. Results from a multicenter international cohort

2021 ◽  
Vol 53 (11) ◽  
pp. 2273-2280
Author(s):  
Michele Marchioni ◽  
Petros Sountoulides ◽  
Maria Furlan ◽  
Maria Carmen Mir ◽  
Lucia Aretano ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Local Recurrence ◽  
Systemic Therapy ◽  
Radical Nephrectomy ◽  
Systemic Treatment ◽  
Survival Rates ◽  
Surgical Removal ◽  
Cancer Specific Survival ◽  
Time To Recurrence ◽  
Kaplan Meier

Abstract Objective To evaluate the survival outcomes of patients with local recurrence after radical nephrectomy (RN) and to test the effect of surgery, as monotherapy or in combination with systemic treatment, on cancer-specific mortality (CSM). Methods Patients with local recurrence after RN were abstracted from an international dataset. The primary outcome was CSM. Cox’s proportional hazard models tested the main predictors of CSM. Kaplan–Meier method estimates the 3-year survival rates. Results Overall, 96 patients were included. Of these, 44 (45.8%) were metastatic at the time of recurrence. The median time to recurrence after RN was 14.5 months. The 3-year cancer-specific survival rates after local recurrence were 92.3% (± 7.4%) for those who were treated with surgery and systemic therapy, 63.2% (± 13.2%) for those who only underwent surgery, 22.7% (± 0.9%) for those who only received systemic therapy and 20.5% (± 10.4%) for those who received no treatment (p < 0.001). Receiving only medical treatment (HR: 5.40, 95% CI 2.06–14.15, p = 0.001) or no treatment (HR: 5.63, 95% CI 2.21–14.92, p = 0.001) were both independently associated with higher CSM rates, even after multivariable adjustment. Following surgical treatment of local recurrence 8 (16.0%) patients reported complications, and 2/8 were graded as Clavien–Dindo ≥ 3. Conclusions Surgical treatment of local recurrence after RN, when feasible, should be offered to patients. Moreover, its association with a systemic treatment seems to warrantee adjunctive advantages in terms of survival, even in the presence of metastases.

Clinical analysis and efficacy of bimanual surgical treatment of retinal detachment in severe forms of proliferative diabetic retinopathy with preoperative preparation with anti-VEGF drugs in combination with the use of the Ngenuity ALCON 3D imaging system

2021 ◽  
pp. 195-198
Author(s):  
D.V. Chernykh ◽  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
3D Imaging ◽  
Imaging System ◽  
3D Visualization ◽  
Preoperative Preparation ◽  
Anti Vegf

The purpose of the study was to evaluate the effectiveness of bimanual surgery with anti-VEGF preparation of patients with severe forms of PDR complicated by traction retinal detachment, with intraoperative use of 3D visualization. Material and methods. Operated on 18 patients with a diagnosis of PDR complicated by traction retinal detachment. Of these, there were 7 patients with type 1 diabetes, type 2 diabetes. There were 5 men and 13 women. The average age was 58 + -2 years. All patients underwent a three-port vitrectomy, using an additional light source, with preoperative preparation with anti-VEGF drugs, using bimanual technique and 3D visualization, using air tamponade. Results and its discussion. As a result of the study, it was found that the visual acuity before the treatment was 0.03 [0.01; 0.1], and 4-6 months after the surgical treatment, 0.3 [0.15; 0.5]. The performed statistical analysis made it possible to establish a statistically significant increase in visual acuity 4-6 months after the treatment. (p = 0.001) Achieved complete anatomical retinal fit. With increased visual acuity. There were 5 complications in the postoperative period. Recurrent hemophthalmos was diagnosed in 3 people, which required repeated surgical intervention. In 2 patients in the postoperative period, DMO developed, which required IVI biodegradable dexamethasone implant. Conclusion. Bimanual, surgical treatment of traction retinal detachments, in severe forms of PDLP, with preoperative preparation with anti-VEGF drugs, and the use of the Ngenuity ALCON 3D imaging system, is one of the effective methods of treatment in this group of patients, and is aimed at reducing both intra and postoperative complications. Key words: рroliferative diabetic retinopathy, vitrectomy, 3D imaging, bimanual surgery, anti-VEGF drugs.

scholarly journals XXVI.—Treatment of Aneurysm by Electrolysis.

1908 ◽  
Vol 28 ◽  
pp. 400-402
Author(s):  
Dawson Turner
Keyword(s):  
Surgical Treatment ◽  
Blood Serum ◽  
The Body ◽  
The Other ◽  
Difficult Question ◽  
Actual Effect

MANY attempts have been made to utilise electrolysis in aneurysms, especially in those thoracic ones that are not amenable to ordinary surgical treatment; it has been hoped that the clotting which occurs around the poles might serve as a nucleus for further coagulation and deposits of fibrin, and that the aneurysm cavity might in this way become partially filled up. Such attempts have not met with much success hitherto, and the purpose of this research has been to endeavour to determine by experiments on blood serum outside the body what the actual effect of electrolysis is so far as regards clotting. Various methods of electrolysing the blood in an aneurysm have been used by surgeons. Ciniselli introduced needles connected with both poles, and reversed the direction of the current every five minutes; of 38 cases so treated, 27 were ameliorated, but none were cured. In the unipolar method one pole only was introduced, and the other was connected with an indifferent pad placed in the vicinity. The difficult question was which pole to introduce. The positive pole gave the firmest clot, but it was thought that it might be difficult to withdraw, and that hæmorrhage or even rupture of the vessel might follow.

scholarly journals Comparative analysis of the quality of life of children with congenital scoliosis after surgical treatment: Extirpation of the hemivertebra from dorsal and combined access

2021 ◽  
Vol 9 (2) ◽  
pp. 153-162
Author(s):  
Dmitry N. Kokushin ◽  
Michael A. Khardikov ◽  
Sergey V. Vissarionov ◽  
Vera V. Sokolova ◽  
Nikita O. Khusainov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Deformity Correction ◽  
Lumbar Vertebra ◽  
Congenital Scoliosis ◽  
Congenital Deformity ◽  
Subsequent Increase ◽  
Level Of Satisfaction

BACKGROUND: Congenital scoliosis with disorders of the formation of the vertebrae is the most common cause of pronounced deformities of the spine in early childhood. This pathology can be treated surgically using various techniques that differ in invasiveness, severity of the condition in the postoperative period, achieved result of deformity correction, and nature of the long-term prognosis. Numerous studies have assessed the quality of life of patients who underwent surgery for acquired deformities, trauma, and degenerative and neoplastic diseases of the spine in adults. However, features of the childs quality of life following surgical technique for congenital scoliosis have not been sufficiently studied. AIM: This study aimed to compare the quality of life of children with congenital scoliosis of the thoracolumbar localization after extirpation of the hemivertebra from the dorsal and combined approaches. MATERIALS AND METHODS: An intergroup prospective analysis of the results of a survey of 60 patients with congenital deformity of the spine against the background of an isolated violation of the formation of the thoracic or lumbar vertebra was carried out. Patients underwent standard surgical treatment. Patients were divided into two groups according to the surgical approach to the abnormal vertebral body: dorsal group (n = 28) and combined group (n = 32). The average age of the patients was 75 (minmax, 26196) months. The follow-up period was 18 months after surgery. To assess the quality of life, a specialized Russian version of the PedsQL v4.0 questionnaire and a modified visual analog scale were used. RESULTS: After surgical treatment of congenital spinal deformity, quality of life indicators decreased more than two times than the results of a preoperative survey. At 18 months postoperatively, the physical activity and psychoemotional state were restored to the preoperative level, while patients of the combined group had a higher satisfaction score on the quality of life (p 0.05). CONCLUSIONS: The combined approach provides the best correction of congenital deformity of the spine and allows maintaining of the achieved result throughout the observation period. In the early postoperative period, the combined group demonstrated a significant decrease in the level of satisfaction with the quality of life, while the pain syndrome was higher than that in the dorsal group. Dynamic observation revealed the leveling of these differences and a subsequent increase in the level of satisfaction with the quality of life of these patients.

scholarly journals Management of Renal Cell Carcinoma- Current Practice in Sub-Saharan Africa

2019 ◽  
Vol 6 (2) ◽  
pp. 1-9
Author(s):  
Ayun Kotokai Cassell ◽  
Mohamed Jalloh ◽  
Bashir Yunusa ◽  
Medina Ndoye ◽  
Mouhamadou Mbodji ◽  
...  
Keyword(s):  
Renal Cell ◽  
Radical Nephrectomy ◽  
Treatment Guidelines ◽  
Cell Cancer ◽  
Sub Saharan Africa ◽  
Renal Masses ◽  
Open Radical Nephrectomy ◽  
Sub Saharan ◽  
Developed Nations

There is a global variation in the incidence of renal masses with the developed nations having a greater incidence. About 80–90% of renal malignancies are renal cell carcinomas (RCC) which account for 2–4% of all cancers. In Africa and the Middle East, the age-standardized incidence for RCC is 1.8–4.8/100,000 for males and 1.2–2.2/100,000 for females. The management of renal cell cancer is challenging. A multidisciplinary approach is effective for diagnosis, staging, and treatment. Guidelines recommend active surveillance, thermal ablation, partial nephrectomy, radical nephrectomy, cytoreductive nephrectomy and immunotherapy as various modalities for various stages of RCC. However, open radical nephrectomy is most widely adopted as an option for treatment at various stages of the disease in sub-Saharan Africa due to its cost-effectiveness, applicability at various stages, and the reduced cost of follow-up. Nevertheless, most patients in the region present with the disease in the advanced stage and despite surgery the prognosis is poor.

scholarly journals IMMUNOREGULATION OF BLOOD SERUM ESTRADIOL AND PROGESTERONE LEVELS IN POSTMENOPAUSAL WOMEN

2019 ◽  
Vol 21 (5) ◽  
pp. 869-876
Author(s):  
A. N. Glushkov ◽  
E. G. Polenok ◽  
S. A. Mun ◽  
L. A. Gordeeva ◽  
V. A. Lutsenko ◽  
...  
Keyword(s):  
Blood Serum ◽  
Human Blood ◽  
Solid Phase ◽  
Biological Effects ◽  
Serum Levels ◽  
Human Blood Serum ◽  
Breast Cancer Patients ◽  
Specific Antibodies ◽  
Healthy Women ◽  
Antibody Levels

Specific antibodies against estradiol (Es) and progesterone (Pg) are known to modulate blood serum concentrations of these hormones and their biological effects after immunization of animals. It was suggested that specific IgA-Es and IgA-Pg could influence on Es and Pg levels in human blood serum. The purpose of this study was to identify the suggested correlations between serum Es and Pg and specific IgA-Es and IgA-Pg in postmenopausal healthy women (HW) and breast cancer patients (BCP). The serum levels of Es, Pg, IgA-Es and IgA-Pg were studied in 226 HW and 633 BCP by means of solid-phase immunoassay. The following results were obtained. The levels of Es in BCP (0.25 nmol/l) were higher than in HW (0.16; р < 0.0001). The levels of Pg were lower (0.79 vs 0.87; р < 0.0001), and individual Pg/Es ratios were lower (3.19 vs 6.64; р < 0.0001). Individual IgA-Pg/IgA-Es ratios correlated with decrease of Es (rs = -0.15; p = 0.029), with increase in Pg (rs = 0.38; р < 0.0001), and with increased Pg/Es ratio (rs = 0.29; р < 0.0001) in healthy women. Similar correlations were determined in BCP (correspondingly: rs = -0.14, р < 0.001; rs = 0.1, р = 0.009; rs = 0.15, р < 0.0001). The decrease of Es and increase of Pg and Pg/Es in BCP were less significant than in HW: the a quotients in regression у = ах+b (y = hormones levels and x = antibodies levels) in BCP were 3 to 4-fold lower than in HW. These peciliarities of interrelations between hormones and specific antibody levels were revealed only in ER+/PR+ BCP but not in ER+/PR- and ER-/PR- BCP. In conclusion, we have confirmed a suggestion about participation of specific antibodies in regulation of steroids levels in human blood serum. The immune regulation of hormonal status was weakened in BCP.

scholarly journals Possibilities of minimally invasive treatments of hemorrhoidal disease

2018 ◽  
pp. 77-82 ◽  
Author(s):  
M. V. Abritsova
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Harmonic Scalpel ◽  
Hemorrhoidal Disease ◽  
Single Center ◽  
Narcotic Analgesics ◽  
Group I ◽  
Minimally Invasive Treatments ◽  
Observation Period

The article presents the results of surgical treatment of patients with stages III to IV hemorrhoids followed by an observation period of 45 days, which is designed to improve the results of surgical treatment of this category of patients. The surgical treatment methods included doppler-guided transanal hemorrhoiddearterialization with mucopexy (DDM) (Group I) and harmonic scalpel hemorrhoidectomy (HSH) (Group II). Operated patients underwent all necessary examinations according to the “per protocol” principle. Study Design: single-center controlled randomized prospective. The effectiveness of DDM was comparable to that of hemorrhoidectomy (HE), which made it possible to significantly reduce the duration of the operation (DDM 17.9 ± 6.1 min, GE 34.5 ± 10.1 min (p <0.01) ), reduce the level of pain in the postoperative period (DDM an average of 2.5 points, HE 4.8 points (p <0.01)), reduce the frequency of narcotic analgesics (DDM an average of 1.3 doses, HE an average of 6.1 doses (p <0.01)) and shorten the period of disability (DDM 14.4 ± 5.2 days, HE 30.3 ± 5.4 days (p <0.01)) patients with stages III to IV disease.

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