[DNA aptamers selection for breast cancer]. / Selektsiia dnk-aptamerov dlia diagnostiki raka molochnoi zhelezy.

A method of selection of DNA aptamers to breast tumor tissue based on the use of postoperative material has been developed. Breast cancer tissues were used as the positive target; the negative targets included benign tumor tissue, adjacent healthy tissues, breast tissues from mastopathy patients, and also tissues of other types of malignant tumors. During selection a pool of DNA aptamers demonstrating selective binding to breast cancer cells and tissues and insignificant binding to breast benign tissues has been obtained. These DNA aptamers can be used for identification of protein markers, breast cancer diagnostics, and targeted delivery of anticancer drugs.

The antitumor effect of magnetic nanodisks and DNA aptamer conjugates.

Here we describe a method of forming large arrays (up to 10(9) pieces) of free magnetic Ni-nanodisks 50 nm thick coated on both sides with layers of 5 nm thick Au. The antitumor effect of the magnetic nickel gold-coated nanodisks and DNA aptamer conjugates was evaluated in vivo and in vitro. Under the influence of rotating magnetic field, the studied nanodisks can cause the death of Ehrlich ascites carcinoma cells.

[Simultaneous radical retropubic prostatectomy, diverticulectomy].

Presented clinical case demonstrates a combination of rare congenital abnormality - giant true diverticula of the bladder - and high-risk prostate cancer, as well as a successful result of simultaneous operation - a radical prostatectomy with diverticulectomy.

[Modified method of retropubic prostatectomy (RMAPE method)].

The article presents the results of the examination and treatment of 125 patients with benign prostatic hyperplasia who underwent surgery in the urological clinic of RMAPE. Retropubic adenomectomy according to the method proposed by the Clinic of Urology and Surgical Andrology of RMAPE was performed in 83 patients, and 42 patients underwent transvesical adenomectomy. In accordance with a number of parameters (timing of surgery, frequency of intra- and postoperative complications, extent of blood loss, duration of bladder drainage, length of hospital stay), a modified method of retropubic prostatectomy demonstrated significantly better results than transvesical adenomectomy.

[Retropubic adenomectomy in patients with a high level of prostate-specific antigen after prostatic biopsy].

Results of examination and treatment were analysed for 58 patients after retropubic adenomectomy performed from February 2008 to June 2010. The examination protocol included assessment of a total score of the scales IPSS and QoL, parameters of uroflowmetry, total PSA, the size of the prostate, number of prostatic biopsies in a high PSA level. The removed adenomatous tissue was examined histologically. By a PSA level, all the patients were divided into 3 groups. Group 1 - 18 patients with a preoperative PSA level above 10 ng/ml, group 2 - 23 patients with a PSA level from 4 to 10 ng/ml, group 3 - 17 control patients with PSA under 4 ng/ml. Mean age of the examinees was 67.7 +/- 7, 68.7 +/- 7.7, 67.9 +/- 8.9 years (p>0.05), respectively. A mean PSA level was 20.9 (10.3-53), 6.6 (4.1-9.9) and 2.4 (1.3-3.9) ng/ml (p<0.01), respectively. A mean size of the prostate was larger in group 1 patients than in the controls: 127.3 (82-185) cm3 versus 100.7 (81-134) cm3 (p<0.05). Median of the number of transrectal multifocal biopsies was 2 (1-7), 1 (1-2) and 0 in groupl, 2 and 3, respectively. Histological examination of the adenomatous tissue detected prostatic adenocarcinoma in 0, 1(4.3%) and 1(5.9%) patients, respectively, while chronic prostatitis at different stages was diagnosed in 6(33.3%), 7(30.3%) and 7(41.2%) patients, respectively. Thus, the above protocol of examination of patients with prostatic adenoma including measurement of a PSA level, conduction of finger rectal examination followed by prostatic biopsy (transrectal saturation procedure is preferable) provides performance of adenomectomy without a risk to miss a clinically significant prostatic cancer even in a PSA level above 10 ng/ml.

[Proximate and remote results of ureterosigmoidostomy with creation of Mainz pouch II and Hasan reservoirs]. / Blizhaishie i otdalennye rezul'taty ureterosigmostomii s formirovaniem po Maints pauch II i Khasanu.

The aim of the study was analysis of short- and long-term results of treating patients operated with intestinal replacement of the urinary bladder by Mintz pouch II and Hasan. Thirty-two ureterosigmostomies with creation of the reservoir from the rectosigmoid angle (17 Mintz pouch II and 15 Abol-Enein operations) were made from 1997-2002. The age of the patients ranged from 16 to 73, the follow-up was 12-72 months. The operation was indicated in infiltrative cancer of the urinary bladder, microcystis of various etiology, extrophy of the urinary bladder. Postoperative urine retention was observed in all the patients both in the day and night time. Renal function remained unchanged or improved in 93% patients. Quality of life was good. All the patients except two with recurrent attacks of pyelonephritis were socially adapted. Able patients resumed their jobs. Early after the operation one woman developed incompetence of the sutures of the reservoir anterior wall which required relaparotomy. Four patients died of local recurrence and/or distant metastases in different terms after surgery. Two patients had reflux with frequent attacks of pyelonephritis as well as a serious impairment of acid-base balance manifesting as hyperchloremic acidosis, the other two patients had late unilateral strictures of the intestinoureteral anastomosis which was reestablished. Thus, updated ureterosigmostomy significantly reduces the rate of complications and is a good alternative to heterotopic and ortotopic urine derivation in contraindications for the operations. Moreover, Hasan's operation allows implantation of delated ureters. In most cases, ureterosigmostomy with formation of reservoir from rectosigmoid angle provides good quality of life in adequate selection of patients.

[Evaluation and prognosis of patients' health status in postop period]. / Otsenka i prognoz sostoianiia bol'nykh v posleoperatsionnom periode.

An estimation of the patient's state and the prognosis can be made at the postoperative period on the basis of results of the assessment of complement activity, blood cell hemolysate activity, filtration of serum and urine. Of the greatest clinical significance for the estimation of the patient's state is complement activity and toxicity of urine.

[Radical treatment of invasive bladder cancer]. / Radikal'noe lechenie invazivnogo raka mochevogo puzyria.

We have conducted a retrospective analysis of radical cystectomy in 53 patients (45 males and 8 females, 85 and 15%, respectively) with invasive bladder cancer (BC) treated in the Research Institute of Urology in 1997-2002. Stages T2N0M0, pT3aN0M0, T3bN0M0, pT4aN0M0, pT4aN1-2M0 were in 4 (7.5%), 13 (25%), 21 (40%), 7 (12.5%), 8 (15%) cases, respectively. Well differentiated transitional cell BC (G1) was detected in 1 (2%) patient, moderately differentiated (G2) in 16 (30%) cases, poorly differentiated (G3) in 36 (68%) patients. The following methods of urine derivation were used: orthotopic plastic surgery (n = 3, 6%), ureterocutaneostomy (n = 4, 8%), Mainz pouch II operation (n = 16, 30%), Hassan operation (n = 5, 9%), Bricker procedure (n = 22, 44%), transureteroanastomosis (n = 3, 6%). In the postoperative period there was one lethal outcome, early complications in 5 (9%) patients, late complications in 9 (17%) patients. Distant metastases to the lungs, bones and iliac lymph nodes after treatment were detected in 3, 2 and 3 patients, respectively. One patient had a local pelvic recurrence. For 53 patients 2-year corrected survival was 68 +/- 12.0%. We have come to the conclusion that the only radical surgical treatment of invasive BC is cystectomy, limitations to which are connected only with complexity of subsequent urine derivation.

[The specificity of interaction between the complement and the lipopolysaccharide with a low activity of the complement (hypothesis)]. / Osobennosti vzaimodeistviia komplementa i lipopolisakharida pri nizkoi aktivnosti komplementa (gipoteza).

Interactions between the complement with a low activity and the lipopolysacharide (LPS) with an extensive concentration range were experimentally investigated in vitro. A model was suggested that provides an explanation to the concentration-related dependence. The complement and LPS were shown, under certain conditions, to form the membrane-attacking complexes, which are not bound with the bacterium membrane and which can lyse any cells. Damages made by the above complexes to endothelial cells of the vessels could result in the onset of the syndrome of disseminated intravascular coagulation (DIC). The results can be used to develop a method applicable to evaluating a concentration of endotoxin and to creating anti-tumor drugs.

[Toxicological screening of biological fluids]. / Skrining toksichnosti biologicheskikh zhidkostei.

Analysis of the results of evaluation of the complement activity, toxicity of the urine, low molecular weight fraction of the blood, and blood cell hemolysis confirmed the suggested simplified model of endotoxicosis and showed that evaluation of the complement activity and urine toxicity is sufficient for tentative laboratory diagnosis of endotoxicosis. Proceeding from these data it is possible to evaluate the patient's status and predict the disease outcome. Laboratory diagnosis is made using a biological test system and toxicity analyzer.

[Diagnostic and therapeutic tactics in various forms of cholangiopathies in children]. / Diagnosticheskaia i lechebnaia taktika pri razlichnykh formakh kholangiopatii u detei.

Seventy children with obstructive cholangopathy were examined in the clinic in the recent 15 years: 48 children had "cholangiopathy of the newborn" and 22 had a cyst of the common bile duct. A total of 44 operations were carried out: on 22 infants with cholangiopathy of the newborn and on 22 with cysts of the common bile duct. The most informative methods for the diagnosis of cholangiopathy in children are as follows: ultrasonic scanning, laparoscopy, ERCPG, aspiration biopsy of the liver, and aspiration cholangiography under control of a laparoscope. Kasai's operation is the operation of choice in obstructive cholangiopathy of the newborn. The operation of choice in cysts of the common bile duct is cystectomy with choledocho- or hepaticojejunostomy on an isolated loop after Roux.