Transurethral resection of the prostate and metastatic prostate cancer

Demonstration of malignant cells in blood specimens collected during transurethral resection of the prostate (TURP) has implicated TURP in the dissemination of prostatic cancer. Of 153 patients who underwent radiation therapy for prostate cancer between January 1977 and June 1990 and were retrospectively analyzed, 93 were evaluable. Fifty-nine patients required TURP before radiation therapy for prostatic obstruction (BPH and/or cancer); the remaining 34 patients underwent radiation therapy after fine-needle aspiration biopsy. No statistically significant difference in failure rate could be detected between these groups, with a failure rate of 47% (28 of 59 patients) at a median follow-up time of 49 months (range, 8 to 146 months) in the TURP group versus a failure rate of 47% (16 of 34 patients) at a median follow-up time of 50 months (range, 3 to 122 months) in the group who underwent biopsy only (Fisher's exact test, P = 0.23). Within the confines of this retrospective study, it appeared that TURP did not enhance the development of metastatic disease.     

Transluminal angioplasty of the vertebral and basilar artery

Transluminal angioplasty of brachiocephalic vessels for atherosclerotic lesions is now being performed in selected cases. We have thus far treated 17 cases of vertebral artery stenosis and one case of basilar artery stenosis by intravascular balloon dilatation techniques. Clinical presenting symptoms included vertebral basilar insufficiency, repeated transient ischemic attacks (TIAs), and multiple strokes. We performed successful transluminal angioplasty in 16 patients with marked narrowing (greater than 70%) of the dominant vertebral artery from atherosclerosis. One patient with basilar artery stenosis with tandem atherosclerotic lesions was also treated by angioplasty techniques. Repeat angiography at 3- to 12-month intervals has revealed continued patency at the angioplasty site. Complications occurred in our one patient with basilar artery angioplasty, who suffered a brainstem infarction after treatment, and in one patient who had a TIA after bilateral vertebral artery angioplasty. Two other patients had residual vertebral stenosis but remained asymptomatic after the procedure. All other patients who had successful dilatation were asymptomatic at 6 months to 2 years (mean, 15 months) of follow-up. These initial studies indicate that vertebral artery angioplasty may be effective for treating high-grade atherosclerotic lesions and for improving blood flow to the posterior circulation. Angioplasty of the basilar artery is technically more difficult and has a higher degree of risk because of the many perforating branches supplying the brainstem.     

Erythrocyte deformability in acute and chronic kidney failure patients

The authors presented some data on the platelet deforming ability in patients with acute and chronic renal failure treated with hemodialysis. Platelet deformity was studied by means of a proposed method of the filtration of platelet suspension through glass filtering funnels with a porous plate (GOST 9775-69). The deterioration of platelet deformity in patients with uremia and its direct correlation with a degree of nitremia were established. It was assumed that the deterioration of platelet deformity resulted in premature cell destruction and anemia development. Platelet deformity can be used as a test to characterize platelet function in patients with renal failure. The problem of the appropriateness of trental therapy was discussed.     

Ideological education of the physician

The article elucidates the importance of ideological grounding of physicians and methods of ideological education. Critics of bourgeois theories on the relationship of science and ideology is given.     

Myocardial metabolism during aortic valve replacement. II. Bolus infusion of cold blood for cardioplegia

Myocardial energy metabolism during hypothermic potassium cardioplegia with blood as the cardioplegia vehicle, given in one or two bolus doses, was studied in eight patients undergoing aortic valve replacement. Myocardial biopsies were taken from the left ventricle 10 min after aortic cross-clamping (a.c.) and immediately before declamping (d.c.) and were analyzed for ATP, creatine phosphate (CP), creatine (C) and lactate. The interindividual range of myocardial temperature was 11-19 degrees C at 10 min a.c. and 11-25 degrees C immediately before d.c. The myocardial ATP concentration fell (17.2 +/- 5.7-12.8 +/- 2.8 mmol X kg-1 dry muscle), the lactate concentration rose (64.7 +/- 35.8-136 +/- 33.8 mmol X kg-1 d.m.) and the total creatine pool (CP + C) was unchanged. Hypothermic blood cardioplegia conferred fairly good initial protection of the myocardium, but the reduction in ATP and the great lactate accumulation towards the end of cardioplegia, especially in patients with myocardial temperature reaching 19-25 degrees C, indicates that such protection is adequate only if the myocardial temperature is maintained between 11 and 18 degrees C.     

Relations between basal ganglia and hippocampus: action of substantia nigra and pallidum

Several interrelationships exist between basal ganglia and hippocampus. The ventral striatum appears to be involved in the control of the dopaminergic nigro-striatal pathway. The caudate, in turn, seems to influence the hippocampal theta rhythm and to inhibit hippocampal spikes. In the present work the role played by globus pallidus pars interna and substantia nigra pars compacta on hippocampal bioelectrical activity is studied. Injection of sodium penicillin i.v. produces steady interictal spikes in the hippocampus. Substantia nigra stimulation induces regular theta rhythm and inhibits the spikes. Pallidal stimulation, on the contrary, appears to strongly enhance epileptiform activity, proceeding to generalised seizure activity. The results are discussed in the light of a putative feedback loop from basal ganglia to hippocampus, probably underlying co-participation of the two subcortical structures in the control of motor behaviour.     

Availability of NSAIDH beta-cyclodextrin inclusion complexes

The diffusion of a series of non steroidal antiinflammatory drugs through a silicone rubber membrane has been studied from suspensions both of the free and beta-cyclodextrin complexes forms at different pH values of the medium. Higher diffusion rates of the complexed forms as compared with the free ones and a rate-limiting effect of the apparent stability constant in the diffusion of the complexes were observed.