Psychophysiological characteristics of patients with chronic prostatitis

The aim of the study was to characterize mental changes in chronic prostatitis (CP) patients after the addition of a combination of local and central reflex physiotherapeutic factors to combined treatment 149 patients with infectious and noninfectious CP entered the study. The study group (n = 94) received combined treatment including physiotherapeutic factors (ANDRO-GIN unit). The control group (n = 55) received standard CP therapy. All the patients have undergone clinical, laboratory, device and psychophysiological examinations. Thus, addition of physiotherapy to combined treatment of CP raises the treatment efficacy and promotes optimization of "an internal picture of illness"--one of major characteristics of the patient's psychological condition.     

Late hemodynamic and clinical outcomes of aortic valve replacement with the Carpentier-Edwards Perimount pericardial bioprosthesis

OBJECTIVES: The aim of this study was to investigate the long-term clinical and hemodynamic outcomes after aortic valve replacement with the Carpentier-Edwards Perimount bioprosthesis (Edwards Lifesciences, Irvine, Calif), which has been used in our institution since 1984. METHODS: From January 1984 to December 1995, the Carpentier-Edwards pericardial bioprosthesis was used for aortic valve replacement in 254 patients (male/female ratio 117:137) with a mean age of 71 years (range 25-87 years). Before the operation, 216 patients (85%) were in New York Heart Association functional class III or IV. The predominant diagnosis was aortic stenosis (n = 219, 86%). Associated surgical procedures included coronary artery bypass grafting in 130 cases (51%), mitral valve replacement in 11 cases (4%), and tricuspid or mitral valve repair in 12 cases (5%). Previous cardiac operations had been performed in 36 cases (14%). Follow-up was 100% complete at a mean of 60 +/- 31 months. Univariate estimates of time-related cumulative probabilities were calculated by the Kaplan-Meier method. Multivariable adjustment was performed by Cox proportional hazards regression. Echocardiography was performed in 61% of long-term survivors. RESULTS: There were 11 early deaths (4%) and 58 late deaths. Actuarial survivals at 5, 10, and 12 years were 80% +/- 3%, 50% +/- 8%, and 36% +/- 9%, respectively. At 12 years the freedom from cardiac death was 73% +/- 7%, the freedom from valve-related death was 84% +/- 11%, the freedom from valve reoperation was 83% +/- 9%, the freedom from primary tissue failure was 86% +/- 9%, the freedom from thromboembolism was 67% +/- 13%, and the freedom from endocarditis was 98% +/- 1%. Echocardiography was performed on long-term survivors (mean follow-up 67 +/- 25 months) and showed that transvalvular peak and mean pressure differences measured with Doppler echocardiography were 23.2 +/- 9.6 and 12.3 +/- 4.8 mm Hg, respectively. Aortic regurgitation was found by Doppler echocardiography to be none or trivial, mild, moderate, and severe in 64%, 30%, 3%, and 1% of patients, respectively. Mean left ventricular mass index was 107.2 +/- 35.3 g/m(2) (118.9 +/- 40.2 g/m(2) in men and 98.8 +/- 28.8 g/m(2) in women) at late follow-up. One third of all patients, regardless of sex (n = 26/64 women and n = 14/45 men), had evidence of left ventricular hypertrophy. However, our analyses indicate that the residual left ventricular hypertrophy was not caused by valve mismatch but was probably multifactorial. CONCLUSION: The Carpentier-Edwards Perimount bioprosthesis has provided satisfactory clinical and hemodynamic outcome. However, at long-term follow-up about one third of the patients being investigated still had left ventricular hypertrophy examined by echocardiography.     

The insulin cardioplegia trial: myocardial protection for urgent coronary artery bypass grafting

BACKGROUND: Small, nonrandomized clinical trials have demonstrated a beneficial effect of solutions containing insulin and glucose on the recovery of myocardial metabolism and ventricular function after cardioplegic arrest and reperfusion. However, no large, blinded, randomized study has yet determined the effects of insulin-enhanced cardioplegia on clinical outcomes after coronary artery bypass grafting. METHODS: The Insulin Cardioplegia Trial was designed to evaluate the clinical impact of insulin-enhanced cardioplegia on patients at high risk undergoing isolated coronary artery bypass grafting for unstable angina. A total of 1127 patients were randomly assigned at operation to receive cardioplegic solution supplemented with 10 IU/L insulin (n = 557) or placebo (n = 570). All personnel with direct patient contact were blinded to randomization group. RESULTS: Overall operative mortality was 2.2%, with no significant differences between groups. The prevalences of postoperative low output syndrome (insulin 10.4%, placebo 9.7%, P =.7) and enzymatic myocardial infarction (insulin 21.0%, placebo 18.8%, P =.3) were not different between groups. The primary composite outcome of low output syndrome and/or enzymatic myocardial infarction revealed no difference between groups (insulin 30.0%, placebo 26.3%, P =.2). CONCLUSIONS: Despite encouraging results from smaller, nonrandomized studies, the Insulin Cardioplegia Trial failed to demonstrate a clinical benefit of insulin-enhanced cardioplegic solution for patients undergoing high-risk isolated coronary artery bypass grafting.     

Laser instrumental surgery in prevention and treatment of retinal detachment. I

Detachment of the retina, developing in the presence of aggravating factors, and its elimination by means of an original laser surgical method became the object of this study. Visulas YAG laser (Karl Zeiss) fitted with an endolaser output was used. Coagulation energy was 0.2-0.9 Wt, YAG laser energy 0.1-9.2 mJ, up to 170 pulses. Analysis was carried out in 38 patients with subretinal adhesions, incarceration of the retina in the scleral wound, and rupture of the retina with its edge folded and elevated. All laser interventions were operations of choice and became the first stage in laser surgical treatment of detachment of the retina. Relapses occurred in 10 (27.7%) cases.     

The effect of tropoxin on the neurogenic and vasogenic inflammation of the dura mater vessels]

Subchronic administration of tropoxin (in doses of 7.5 and 10 mg/kg) caused dose-dependent blocking of 131I-albumin plasma transudation from the dura mater vessels, induced by electrical stimulation of the trigeminal ganglion and intravenous infusion of the agonist of 5-HT2B/2C receptors metachlorophenylpiperazine. The antimigraine agent metisergid produced a similar effect. A single injection of metisergid and tropoxin did not block albumin transudation. A 3 mg/kg dose of mianserin prevented the blocking effect of tropoxin and metisergid on plasma exudation into the dura mater. It is suggested that the mechanism of the tropoxin antimigraine effect is realized through the presynaptic 5-HT1 receptors of afferent endings of the trigeminal nerve and the postsynaptic 5-HT2B/2C receptors of the dura mater vessels.     

Radiation-epidemiological analysis of incidence of non-cancer diseases among the Chernobyl liquidators

The work is concerned with assessment of radiation risks for non-cancer disease among the Chernobyl liquidators from 1986 to 1996. As of 1 January 1999, the Russian National Medical and Dosimetric Registry contains medical and dosimetric data for 174,000 liquidators. The cohort of 68,309 liquidators for whom best verified medical data are available is discussed. The dose dependency of incidence of non-cancer diseases was estimated by the cohort method and using the software package Epicure. For some classes of non-cancer diseases among liquidators, statistically significant estimates of radiation risk were derived for the first time. The highest excess relative risk per 1 Gy was found for cerebrovascular diseases; ERR Gy(-1)=1.17 at the 95% confidence interval (0.45; 1.88).     

COX-2 expression is induced by UVB exposure in human skin: implications for the development of skin cancer

Extensive documentation has validated the role of UV irradiation as a tumor initiator and promoter, inducing both squamous and basal cell carcinomas. Human epidermis is a tissue which undergoes active metabolism of arachidonic acid to prostaglandins which is regulated by the action of prostaglandin H synthase (also known as cyclooxygenase). One mechanism for the promotional activity of UV light may involve its ability to induce prostaglandin formation. Work in our laboratory has demonstrated that acute exposure of human keratinocytes to UVB irradiation results in increased production of prostaglandin E2 (PGE2). When cultured human keratinocytes were examined after irradiation with 30 mJ/cm2 UVB in vitro, Western blot analysis showed a 6-fold increase in COX-2 protein which was evident at 6 h and peaked 24 h after irradiation. Furthermore, when human subjects were irradiated on sun- protected skin with up to four times their minimal erythema dosage (MED) and biopsied 24 h later, upregulation of COX-2 protein expression was observed via immunofluorescence microscopy. RNAase protection assays supported this observation, showing induction of COX-2 message which peaked at approximately 12 h following irradiation in vitro. Furthermore, human squamous cell carcinoma biopsies exhibited strongly enhanced staining for COX-2 protein via immunohistochemistry and Western analysis when compared to normal non-sun-exposed control skin. Together, these data demonstrate acute upregulation of COX-2 via UVB irradiation and suggest the need for further studies of COX-2 expression as a potential pharmacological target mediating human skin tumor development.      

Adoptive laser immunotherapy and photodynamic therapy in ORL oncology

Present-day developments in oncological applications of laser therapy are adaptive laser immunotherapy (ALIT) and photodynamic therapy (PDT). ALIT (helium-neon laser) was used in 35 ENT-cancer patients to irradiate immunocompetent leukocytes isolated from blood in an Amino cell separator. The use of ALIT in the combined treatment of our patients improved their health condition. Cytological, immunochemical and immunological examinations of blood revealed an increased count of activated lymphocytes, normalization of acute-phase proteins, stimulation of cell-mediated immunity and nonspecific resistance. The pharmacokinetics and photodynamic activity of porphyrin compounds in mice with inoculated tumors were investigated. Experimental observations demonstrated that the application of photodynamic therapy of hematoporphyrins in ENT-oncology seems very promising.