IMPORTANCE OF PROSTATIC SPECIFIC ANTIGEN (PSA) IN CLINICAL PRACTICE : OUR EXPERIENCE

A total of 89 patients in the age group of 50-92 years having different histopathologically proven prostatic conditions were analysed with prostate specific antigen (PSA) and clinical co-relation undertaken. PSA levels were found to be significantly higher (p < 0.05) in 48 carcinoma prostate cases (mean 93.16 ± 50.75 ng/ml) as compared to 32 benign prostatic hyperplasia (mean 4.66 ± 3.85 ng/ml). Similarly, levels were considerably reduced in 15 post-operative adenocarcinoma cases (mean 10.77 ± 9.65 ng/ml) as compared to their pre-operative samples (mean 93.16 ± 60.75 ng/ml). PSA levels were moderately higher in 9 cases of prostatitis (mean 13.28 ± 4.53 ng/ml). A very high degree of sensitivity, specificity and positive predictive value of PSA e.g. 95.8%, 75.6% and 82.2% respectively was found in adenocarcinoma cases, when levels of PSA were > 10 ng/ml. Thus it necessitates a detailed and thorough examination in such cases to come to final conclusion and early management of the cases.KEY WORDS: Prostatic Specific Antigen (PSA)     

CD3AK细胞两种输入方法的不良反应观察

目的探讨减少CD3AK细胞输入不良反应的最佳技术操作方法。方法将62例接受CD3AK细胞输入治疗的慢性乙型肝炎患者分为两组:用CD3AK细胞输入与白介素-2混合静脉输入的15例患者为混合输入组,采用CD3AK细胞、白介素-2分别单独静脉输入的47例患者为分开输入组,观察两组输入反应情况。结果两组头痛、发热、畏寒的发生率,经统计学处理,有显著性差异(P<0.01)。结论取CD3AK细胞、白介素-2加入生理盐水分别单独输入的方法,可减轻患者不良反应,顺利完成疗程,达到预期的治疗效果。     

Morphofunctional status of the gastric mucosa in acalculous diseases of the biliary tract

AIM: To study morphofunctional peculiarities of gastric mucosa in native and migrant rural population of North Siberia. MATERIAL AND METHODS: A comprehensive clinicomorphological examination including physical examination, ultrasonic scanning, cholecystography, duodenal intubation, intragastric pH-metry, esophagogastroduodenoscopy, quantitative and qualitative investigations of gastric mucosa was conducted in 148 migrants (Russians, Ukrainians) and 165 evenks living in Evenkia. RESULTS: In both population groups, more often in the migrants, in cholecystitis vs dyskinesia patients frequency of atrophic changes in gastric mucosa was higher while acid production in the stomach was lower, antral gastritis more active. CONCLUSION: Morphofunctional condition of the stomach influences the condition of the bile tract in native and migrant population of North Siberia.     

Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiation

Percutaneous endoscopic gastrostomy (PEG) tubes have largely replaced nasogastric tubes (NGT) for nutritional support of patients with head and neck cancer undergoing curative (chemo)radiotherapy without any good scientific basis. A randomized trial was conducted to compare PEG tubes and NGT in terms of nutritional outcomes, complications, patient satisfaction and cost. The study was closed early because of poor accrual, predominantly due to patients’ reluctance to be randomized. There were 33 patients eligible for analysis. Nutritional support with both tubes was good. There were no significant differences in overall complication rates, chest infection rates or in patients’ assessment of their overall quality of life. The cost of a PEG tube was 10 times that of an NGT. The duration of use of PEG tubes was significantly longer, a median 139 days compared with a median 66 days for NGT. We found no evidence to support the routine use of PEG tubes over NGT in this patient group.     

Suitable survival and half-life of red cells after frozen storage in excess of 10 years

To examine the appropriateness of the Food and Drug Administration's 10-year storage time for previously frozen red cells, 24-hour posttransfusion survival studies were performed, and the half-life of 3 units of autologous red cells that had been stored for 13.5, 14, and 17 years, respectively, was measured. The units had acceptable freeze-thaw-wash recovery (83.3-91.4%). When a 51Cr label was used for the previously frozen red cells and a simultaneous 52Cr label for freshly drawn autologous red cells was used as a comparison, it was seen that the previously frozen cells had normal 24-hour posttransfusion survival (75.1-88.4%) as well as normal half-life (23-33.7 days). These findings support further extension of the maximum allowable storage time for previously frozen red cells.     

Helicobacter pylori and peptic ulcer in the population of Khakasiia

AIM: To investigate the relationship between Helicobacter pylori infection and ulcer in population of Khakasiia. MATERIALS AND METHODS: An epidemiological study of dyspepsia and ulcer prevalence in Khakasiia population covered 1052 patients (564 residents and 488 immigrants). 339 patients were examined endoscopically. Helicobacter pylori (HP) was detected in gastric mucosa using light microscopy after Giemsa staining in 214 patients (104 immigrants and 110 residents). RESULTS: Prevalence of ulcer and HP were 6.1, 1.5% and 69.2 and 88.9% in immigrants and residents, respectively. HP index, degree of dissemination and adhesion in gastric mucosa of immigrants with duodenal ulcer were higher than in controls. The same but less manifest tendency was in the residents. CONCLUSION: The population of the Siberian South has ethnic features of ulcer prevalence and pathogenesis. It is thought more valid to study mechanisms of ulcerogenesis through quantitative rather than qualitative characteristics of HP infection.     

Curative to Palliative Care-Transition and Communication Issues: Surgeons Perspective

Transition of a cancer patient from curative to palliative stage is one of the most difficult and challenging phases of cancer care both from patient and physician point of view. Most of the time the treating surgeons are expected to facilitate this transition but due to a number of reasons surgeons often fail to fulfill this crucial responsibility. This article highlights the various issues involved in the transition phase from a surgeons perspective.