Diagnostic technique for severity level of varicocele and its recuring |
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IPC classes for russian patent Diagnostic technique for severity level of varicocele and its recuring (RU 2403871):
 Method of bone resorption to remodelling analysis / 2403870
Invention refers to medicine, namely to biochemistry, surgery and dentistry. The bone resorption to remodeling analysis is based on the biochemical blood examination. An the blood coefficient K1 is calculated by formula: K1=[(PTH:A)+(TNF-α:B)+(IL-1β:C)]:3, where PTH is the parathyroid hormone concentration (pg/ml) in the patients, A is the same value in healthy individuals, TNF-α is the level of tumor necrosis factor -α (pg/ml) in the patients, B is the same value in healthy individuals, IL-1β is the interleukin-1β concentration (pg/ml) in the patients, C is the same value in healthy individuals to derive the blood coefficient K2 by formula: K2=[(calcitonin: D) + (osteocalcin: E)]:2, where the calcitonin concentration (ng/ml) in the patients, D is the same value in healthy individuals, the osteocalcin level (ng/ml) in the patients, E is the same value in healthy individuals. Then the bone metabolism control coefficient (BMCC) is calculated by formula BMCC=K1:K2, and the higher BMCC than 1.17, the more intensive resorption prevails over remodelling; and the lower BMCC than 0.83, the more intensive remodelling prevails over resorption.
Method for assessment of kidney function in felines by measurement of ghrelin hormone levels / 2403573
Method for assessment of kidney function in felines includes determination of observed level of ghrelin in tissue or biofluid of feline and establishment of direct dependence of observed level of ghrelin on kidney function by comparison of observed level of ghrelin with reference level of ghrelin that characterises normal kidney function. Method for diagnostics of kidney disease in felines includes detection of observed level of ghrelin in tissue or biofluid of feline and comparison of observed ghrelin level with referent level of ghrelin, which characterises normal kidney function, where observed level lower than reference level indicates kidney disease or predisposition to it. Method for detection of kidney disease beginning in felines includes monitoring level of ghrelin in tissue or biofluid of feline for a certain period of time; where beginning is identified, if at any moment of time level of ghrelin decreases compared to initial level that characterises healthy kidney function. Diagnostics set includes (a) one or more test materials to detect observed levels of ghrelin in tissue or biofluid of feline; and (b) one or more user-available mediums bearing the following information: (i) reference level of ghrelin that corresponds to a specific feline; and (ii) algorithm of direct dependence of observed ghrelin level relative to reference level on kidney function or reverse dependence of observed ghrelin level relative to reference level on availability of kidney disease or predisposition to kidney disease.
Diagnostic technique for foetal maturity / 2399058
There are determined daily excretion of progesterone metabolite - pregnandiol (Pd), foetal steroids - 16α-hydroxy-ethiocholanolone (16α-OH-Et), 16α-hydroxy-androsterone (16α-OH-An), 16α-hydroxy-dihydroepiandrosterone (16α-OH-DHEA) and oestradiol (Oe) in pregnant women on their 37-42 weeks of pregnancy by capillary gas chromatography. A mature foetus is indicated by the following indices: daily Pd excretion is 150.4-348.3 mcmol/24 hour, 16α-OH-Et - 7.9-16.9 mcmol/24 hour, 16α-OH-An - 6.4-12.6 mkmol/24 hour, 16α-OH-DHEA - 15.4-26.1 mcmol/24 hour, Oe - 24.0-38.7 mcmol/24 hour, while an immature foetus show the indices as follows: daily Pd excretion 80.1-150.2 mcmol/24 hour, 16α-OH-Et - 5.8-7.8 mcmol/24 hour, 16α-OH-An - 4.6-6.3 mcmol/24 hour, 16α-OH-DHEA - 10.2-15.3 mcmol/24 hour, and Oe - 14.5-15.6 mcmol/24 hour, and in a overmature foetus, daily Pd excretion, 16α-OH-Et, 16α-OH-An, 16α-OH-DHEA and Oe are considerably lowered and are less than 50.0 mcmol/24 hour, less than 12.0 mcmol/24 hour, less than 5.8 mcmol/24 hour, less than 4.6 mcmol/24 hour, less than 10.2 mcmol/24 hour, respectively.
Method for prediction of clinical course in disseminated skin melanoma patients / 2399057
Method is implemented by blood analysis for total and free triiodothyronine after the termination of integrated treatment to derive the total to free triiodothyronine ratio, and it is within the range 0.26-0.31, steady state is predicted to be kept in the patients; the ratio within the range 0.19-0.22 ensures to predict the disease generalisation. Technical and economic efficiency of the invention consists in the fact that the derived prognosis factor is an informative laboratory covariant of the favourable or unfavourable development of the pathology.
Method for prediction of effectiveness of neoadjuvant automyelochemotherapy in patients with recurrent breast cancer / 2393484
Prior to begin the therapy, the patient's blood is tested for oestradiol concentration. If the concentration is 18.40 to 29.40 nmol/l, tumour size loss after the neoadjuvant automyelochemotherapy by 67-70% is predicted, that is a partial regress of the tumour, while oestradiol concentration 208.50 to 1541.0 nmol/l enables to predict the tumour size loss by 5-45% that is process stabilisation.
Method for determination severity level of trophological insufficiency in patients with chronic obstructive pulmonary disease / 2390026
Body weight index (BWI) is evaluated; if it is lower than 20 kg/m2, additional analysis is needed to determine the serum leptin concentration. If it is within 16.01±0.64 to 10.15±0.91 ng/ml, the absence of trophological insufficiency is diagnosed, while the values within 5.49±0.46 to 2.26 ng/ml enable to diagnose trophological insufficiency of medium severity, while the values 1.90 to 0.72±0.09 ng/ml indicate severe trophological insufficiency.
Method of forecasting retrocessions of larynx cancer / 2389030
In patients suffering from larynx cancer after surgical oncotomy in the course of dispensary observation levels of androsteron and estradiol in 24-hour collection urine are examined and their ratio to each other are determined. At ratio level more than 3 emergence of disease retrocession or metastasis in the near future is forecasted. At ratio level lower than 3 a long-lasting recurrence-free period is forecasted.
 Diagnostic technique for desynchronosis of hypophysial thyroid system in patients with severe bronchial asthma, previously not taking glucocorticoid therapy / 2382366
Diagnostic technique for desynchronosis of hypophysial thyroid system in the patients with severe bronchial asthma refers to medicine. Substance consists that blood of the patients is radioimmunoassayed for concentration of TSH, T3, T4 hormones. The obtained data are processed to draw a graphic curve of circadian rhythm for each hormone that provides a basis to determine individual acrophase and batiphase time. The acrophase (confidence interval) TSH development biorhythm 9 h 11 min (confidential interval 4 h 57 min to 13 h 26 min), T3 hormone - 15 h 01 min (confidential interval 8 h 05 min to 21 h 57 min) T4 hormone - 16 h 34 min (confidential interval 8 h 55 min to 24 h 13 min), and batiphase of circadian TSH secretion rhythm 21 h to 22 h, T3 - 2 h to 4 h, T4 4 h to 5 h ensure to diagnose apparent desynchronosis of hypophysial thyroid system.
Method for predicting depressive behaviour in aged primate, rates of aging and development of stress-dependent pathological changes / 2377570
Invention refers to medicine and veterinary science and can be used for predicting depressive behaviour of an aged primate, rates of ageing and development of stress-dependent pathological changes. According to the claimed invention, an aged primate is examined for psychoemotional reaction on soft and acute psychoemotional stress effect, molar concentration ratio of cortisol and dehydroepiandrosterone sulphate in peripheral blood plasma and percentage concentration of cortisol in peripheral blood plasma in the evening (20 o'clock 45 minutes - 21 o'clock 15 minutes) to concentration of cortisol in peripheral blood plasma in the morning (8 o'clock 45 minutes - 9 o'clock 15 minutes) to predict depressive behaviour in the aged primate with accelerated rates of ageing and development of stress-dependent pathological changes in depressive reaction on soft and acute psychoemotional stress effect, if molar concentration ratio of cortisol and dehydroepiandrosterone sulphate in peripheral blood plasma is not less than 4.3, and concentration of cortisol in peripheral blood plasma in the evening to concentration of cortisol in peripheral blood plasma in the morning is not less than 66%.
Method of estimating efficiency of neoadjuvant autohemochemotherapy in patients suffering from carcinoma of cervival stump / 2375063
Invention concerns medicine, namely oncology and can be used in estimation of clinical effectiveness factors in treatment of carcinoma of cervical stump. Daily urine is analysed for estradiol content and if decreased after treatment from initial level within 8.44-12.85 nmol/days, positive antineoplastic effect of treatment is stated, and if urine estradiol content is maintained in the treated patients within 8.81-11.38 nmol/days, the absence of antineoplastic effect is stated. The obtained results allow considering dynamics of estradiol content in daily urine of the patients suffering from carcinoma of cervical stump prior to AHCT as an additional laboratory test to estimate efficiency of presented pharmacotherapy. Observed positive clinical effect is confirmed by higher operability and improved life quality of the patients.
Method of bone resorption to remodelling analysis / 2403870
Invention refers to medicine, namely to biochemistry, surgery and dentistry. The bone resorption to remodeling analysis is based on the biochemical blood examination. An the blood coefficient K1 is calculated by formula: K1=[(PTH:A)+(TNF-α:B)+(IL-1β:C)]:3, where PTH is the parathyroid hormone concentration (pg/ml) in the patients, A is the same value in healthy individuals, TNF-α is the level of tumor necrosis factor -α (pg/ml) in the patients, B is the same value in healthy individuals, IL-1β is the interleukin-1β concentration (pg/ml) in the patients, C is the same value in healthy individuals to derive the blood coefficient K2 by formula: K2=[(calcitonin: D) + (osteocalcin: E)]:2, where the calcitonin concentration (ng/ml) in the patients, D is the same value in healthy individuals, the osteocalcin level (ng/ml) in the patients, E is the same value in healthy individuals. Then the bone metabolism control coefficient (BMCC) is calculated by formula BMCC=K1:K2, and the higher BMCC than 1.17, the more intensive resorption prevails over remodelling; and the lower BMCC than 0.83, the more intensive remodelling prevails over resorption.
Method of detection of specific liver disease in leprosy patients / 2403869
Invention refers to medicine, namely to leprology, and can be used particularly for the detection of specific liver disease in the leprosy patients. Blood serum of the leprosy patients is analysed to determine the level of US-M.leprae and DIS-BSA leprosy mycobacteria antigen antibodies, and also the concentration of alpha-1-antitrypsin. If observing the level of antibodies to two antigens increased as compared to a norm and the concentration of alpha-1-antitrypsin increased higher than 346.7 mg/dl, liver disease is detected in the leprosy patients.
Method of risk evaluation of metabolic syndrome in patients with chronic cholecystitis / 2403868
Invention refers to medicine, namely to gastroenterology and cardiology, can be used in medical institutions for determination of severity level of metabolic disorders and risk of metabolic syndrome in the patients suffering chronic cholecystitis. For risk evaluation of metabolic syndrome in the patients with chronic cholecystitis by the severity of immune-metabolic disorders, the following significant diagnostic characters are used: fasting glucose, apoprotein atherogenicity coefficient (apoB/anoAl), high density lipoprotein cholesterol, T-helpers and T-suppressors ratio, phagocytic index. The derived values are entered in an arithmetic formula to evaluate the risk of metabolic syndrome by the severity level of immune-metabolic disorders by total value expressed in standard units.
Preoperative differential diagnostic technique of peripheral nerve tumours / 2403862
Invention refers to medicine, namely to neurosurgery. It involves clinico-neurological examination to be carried on. A degree of nerve conduction abnormality is determined. Neurofibroma is diagnosed by the presence of pain symptom, a palpated space-occupying lesion and the absence or functionally insignificant decrease in nerve trunk conductivity. Neurinoma is diagnosed by the presence of pain symptom, a palpated space-occupying lesion and the evident functionally significant abnormalities of nerve trunk conductivity.
Method for prediction of cerebral metastases of pulmonary cancer / 2402280
Invention refers to medicine, namely to oncology and can be used for prediction of cerebral metastases of pulmonary cancer The method involves the determination of prognostic indices by clinical anamnestic data If observing such prognostic indices as 55-60-year-old age in males, diagnosed peripheral adenocarcinoma or small cell carcinoma of right lung, T2-T3N2 (IIIA) stage, non-administered adjuvant therapy, the occurrence of cerebral metastases, mainly in the left brain is predicted within approximately 10 months after a primary tumour has been detected.
Method for prediction of myopia transition to progressive form / 2402279
Invention refers to medicine, particularly to ophthalmology, can be used for prediction of progression of myopia acquired in schools in 10-14 and 15-17 year old children. Blood serum is analysed for cartilage glycoprotein-39 with the use of sandwich-type enzyme immunoassay. If its concentration is within 34.7-53.4 ng/ml in 10-14-year-old children and 22-56.3 ng/ml in 15-17-year-old children, a permanent course of myopia is predicted. The concentration 18.5-33.9 ng/ml in 10-14-year-old children and 53.7-69 ng/ml in 15-17-year-old children enables to predict a progressive course of myopia.
Method of noninvasive evaluation of histology activity index in patients with chronic viral hepatitis / 2402278
Method relates to medicine, hepatology. In a patient with chronic viral hepatitis, abdominal ultrasound is applied. The following diagnostic criteria are observed: thickness of left lobe of liver; length of spleen, liver size, liver echogenicity, diametre of splenic vein; diametre of superior mesenteric vein, diametre of hepatic artery, mean blood velocity in portal vein. The histology activity index is calculated by an original mathematical formula.
 Method of optimising diagnosis of stages of acute disseminated intravascular coagulation / 2402277
Invention refers to medicine, namely to aggressive medical therapy, resuscitation science, critical care medicine, laboratory diagnostics and can be used by resuscitators, intensivists, laboratory doctors for well-timed diagnosis and consequently, for individualised aggressive medical therapy of acute disseminated intravascular coagulation. The integrated assessment of links of haemostatic system and the clinical appraisal of organ dysfunction are applied in a measurer, and when observing structural hypercoagulation characterised by fibrinogen level increase, thrombocyte activity increase, growth of soluble fibrin complex (SFC) level, and also when observing chronometric hypercoagulation characterised by time tests, palette-derived factor 4 activity (P4) with manifested petechial haemorrhage and organ dysfunction, and coagulation cascade activation with underlying depression of antithrombin III and protein C, a hypercoagulation stage of acute DIC is diagnosed. Chronometric hypercoagulation by Activated partial thromboplastin time (APTT), INR, fibrinogen and P4 with manifested signs of structural hypocoagulation by thrombin time prolongation and D-dimer activity increase with underlying further intensification of anticoagulant system deficiency, progression of target organs dysfunction and mixed haemorrhage show a transitive stage of acute DIC. If observing said hypocoagulation changes and disturbed fibrinolytic activity with prevailing either decompensated organ and tissue dysfunction, or hemorrhagic syndrome up to system haemorrhages, or their combination with hemorrhagic syndrome characterised by polymorphism of clinical picture and localisation: petechial-haematoma haemorrhage at the stress-induced stomach ulcers, hematuria, a coagulopathy stage of acute DIC is diagnosed that is characterised either by depression of fibrinolysis, or preserved fibrinolytic activity, or by activation of secondary fibrinolysis, or by acute primary fibrinolysis.
Diagnostic technique for respiratory function of erythrocyte in pregnant women by erythrocyte glutathione reductase activity test in aggravated herpes virus infection / 2402276
Invention refers to medicine, namely to diagnostic techniques and concerns a diagnostic techniques technique for respiratory function of peripheral blood erythrocytes in pregnant women in herpes virus infection episode in the third trimester. The technique consists in determination of glutathione reductase and herpes virus antibody titre concentration by the enzyme immunoassay in peripheral blood in pregnant women suffered from a herpes virus infection episode. If glutathione reductase concentration is 8.36±0.137 E/g Hb (ref. - 7.82±0.185 E/g Hb), herpes virus antibody titre is 1:6400. If herpes virus antibody titre is increased to 1:12800, erythrocyte glutathione reductase concentration is decreased 4.48±0.22 E/g Hb.
 Method of chewing system functioning evaluation / 2402275
Method of chewing system functioning evaluation refers to medicine, particularly to orthopaedic dentistry. A chewing test involves face bow recording in patients. A face bow index (FBI) is calculated by formula:
 Method for predicting the result of acute peroral intoxication with cauterizing liquids / 2244930
At patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
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FIELD: medicine. SUBSTANCE: invention refers to medicine, namely to urology and vascular surgery. The sex hormones level in an involved vein is considered to be a criterion of the severity level of varicocele. There are evaluated the following sex hormones: testosterone, estradiol, progesterone simultaneously in the pampiniform plexus veins of a left ovary and in the peripheral vein of a bend of elbow, with determining the ratio of the sex hormones level in a healthy vein of the bend of elbow to the varicocele-involved pampiniform plexus vein. If said ratio of the sex hormones level is 1:10 to 1:50, the first degree of varicocele is diagnosed. Recurrent varicocele and the second degree of varicocele is diagnosed by the ratio of the sex hormones level in the healthy and involved veins 1:50 to 1:100 times (i.e. hormones concentration in a varicose vein is increased in tens times). If observing the ratio of the sex hormones level in the healthy vein and the involved vein of the pampiniform plexus veins of the left ovary increasing more than in 1:100, the third degree of varicocele is diagnosed. Surgical intervention is indicated if the ratio of the sex hormones level is diagnosed more than 1:50. EFFECT: method allows improving diagnostic accuracy of varicocele severity and diagnosing the recurrence on the basis of objective numerical information, and also accurately stating indications for varicocele surgery. 5 cl, 4 tbl, 5 ex
The invention relates to medicine, namely to urology and vascular surgery, and is intended to determine the severity of varicocele and identify relapse, and determine the indications for surgical treatment There is a method of determining varicocele by rentgenografii seed Vienna and ultrasound scan of the veins of the spermatic cord (White SR, Galeev, R., X. Safin G.M. "Phlebography varicocele". Kazan medical journal, 1988, No. 3, s-175). This method of rentgenografii gives you the opportunity to confirm the presence of varicocele, to determine the structure of the seed of Vienna, the presence of anastomoses. However, it is technically difficult to perform, is invasive, requires expensive equipment and radiopaque substances, creates radiation load on the patient, the possible common complications of embolization testicular vein: - allergic reaction to contrast medium (3.5% of cases); temporary pain in the left iliac region (29%); - thrombophlebitis of veins botryoidal plexus (4%); - perforation of the vessel wall and thrombosis of the venous system of the kidney. There is a method of detecting recurrence of varicocele using ultrasonic Doppler mapping. The method consists in determining the speed of blood flow by seed Vienna by ultrasound scan is of real-time Doppler echography). Determine the difference between the maximum velocity of blood flow in the affected and the healthy contralateral seed Vienna. The difference between the maximum blood flow velocity in seed Vienna, affected and contralateral seed Vienna, exceeds 50%. If the value of the last from 30% to 50%, the result is regarded as doubtful, less than 30% negative (RF patent No. 2177727, publ. 2002.01.10.). The method of ultrasonic scanning allows you to judge the diameter of the seed of Vienna, but does not allow to determine the severity of varicocele, it is not possible to distinguish phlebectasia from varicocele, it is not possible to determine the degree of varicocele in accurate digital measurement, does not reveal the role of sex hormones in the pathogenesis of varicocele. Closest to the proposed method is a classification developed Asseciories (1964), which takes into account the anatomical, functional and clinical features of varicocele. The author proposed to divide varicocele on three levels: I degree - all along the spermatic cord veins Lutovinovo plexus extended, but do not fall below the upper pole of the testis; II degree - veins just plexus extended stretch shell spermatic cord and fall down, reaching different levels between the poles of the egg. The testis is significantly lowered, lowered cremasteric R is Flex. In the horizontal position of the patient dilated veins spadats. Patients experiencing significant or a stronger feeling of heaviness or pain in the corresponding testis, mainly during or after physical labor. III degree in the vertical position of the patient dilated veins in the form of testovaty conglomerate sink to the bottom of the scrotum, which is deformed scrotum. Egg happens when swollen or atrophic, less unchanged. The cremaster reflex is absent or drastically reduced. Patients with physical tension and often alone feel the heaviness, pain in the corresponding testis decreased work capacity (Nechiporenko AS "ON the classification and treatment of varicose veins of the spermatic cord". // Urology. - 1964. No. 2. - Pp.28-32). Classification AS Nechiporenko wide application not received because it is too large, the clinical symptoms of the disease are extremely varied and the above-mentioned symptoms can occur in any stage of the disease, or they may not be, if any, may vary at different stages. Currently used classification Nagapattinam (1981) (Tiktinsky O.L., Mikhailichenko Day.- SPb.: Media Press, 1999.- pp.261), which is more simplified than the classification AS Nechiporenko, and takes into account the grade the severity of varicocele and changes of trophic eggs: I degree - varicose veins revealed by palpation at natureway the patient in the upright position of the body; II degree - visually determined dilated veins(a symptom of "earthworms"), the size and consistency of the testicle is not changed, the horizontal position of Vienna spadats; Grade III - severe dilatation of the veins botryoidal plexus, reduced testicular and change its texture (textualist). Thus, both clinical classification based on the complaints of patients with varicocele and physical data (palpation, inspection), which is a subjective criterion. The objective of the proposed diagnostic method is to develop an objective, easily reproducible method for the diagnosis of the severity of varicocele and its recurrence after surgical treatment, or after endovascular embolization. The purpose of the invention is to improve the accuracy of diagnosis of the severity and recurrence of varicocele, determine the role of sex hormones in the pathogenesis of varicocele and the establishment of clear diagnostic criteria for the indications for surgical intervention The technical result of the invention is achieved in that in the method for the diagnosis of the severity of varicocele and its recurrence, including clinical studies patient, conduct blood sampling simultaneously in the PE fericelli Vienna elbow bend and in Vienna Lutovinovo plexus of the left testis of a patient, determine the level of sex hormones in serum (testosterone, estradiol, progesterone), then, with respect to levels of sex hormones in healthy Vienna elbow bend to their level in affected due to varicocele Vienna Lutovinovo plexus of the left testicle from 1:10 to 1:50, diagnosed with first degree varicocele, at the specified level of hormones from 1:50 to 1:100 diagnose recurrent varicocele and second degree varicocele, when more than 1:100 diagnosed with third degree varicocele, and with increasing concentrations of sex hormones less than 1:10, diagnose the absence of varicocele. Blood sampling is conducted by venesection or venipuncture Vienna Lutovinovo plexus of the left testicle, with straining effort of the patient, or by compression of the proximal portion of the vein to simulate venous stagnation in a retrograde reflux of blood in the presence of varicocele in a period of not more than five minutes, which allows to neutralize the cyclic diurnal fluctuations in the level of testosterone and estradiol serum. New in the proposed method is that the severity of varicocele is determined with the aid of hormone research; examine the level of sex hormones in a patient, first, in two places at once, namely, in a normal (typical for many kinds of blood collection), and putaminal from the cubital vein, as well as in the localization of varicocele (one of the veins Lutovinovo plexus in the scrotum on the left), and secondly, in relation defined in the serum levels of male and female hormones in the patient. The authors almost (based on empiricheski collected facts) and an effective, affordable way determined the severity of varicocele. A well-known technique of blood sampling to determine the level of hormones, including sex, lies in the fact that the patient in the morning, on an empty stomach perform venipuncture Vienna elbow bend and carry out blood sampling for determination of sex hormones (Clinical endocrinology: a Guide / edited NetStorage, M.: Medicine, 1991. - s-415), (RF patent No. 2231289, publ. 2004.06.10). However, as mentioned above, that varicocele is observed stagnation of blood in the veins Lutovinovo plexus, the left testicle, for comparative analysis blood samples were taken: Vienna elbow bend, Vienna Lutovinovo plexus of testicular left (in the localization varicocele) and for comparison, Vienna Lutovinovo plexus on the right. On the fact of blood in the affected lesion during operation rather larger number of patients, the authors noted was the fact that the sharp increase in the level of female and male sex hormones in the lesion varicocele - Vienna Lutovinovo plexus. A marked increase in the level of hormones would be what about recorded during the operation for varicocele and depended on the extent of damage to the veins. The comparison of the levels of sex hormones in a patient in healthy Vienna and amazed allowed the authors to find a system for assessing the severity of varicocele. The proposed method of determining the level of sex hormones produced in the testes (testosterone, estradiol, progesterone, and others) and in the serum of patients with varicocele, revealed a significant difference in the concentration of sex hormones. Varicocele, as a result of stagnation of blood, the concentration of sex hormones is always higher in testicular Vienna, and this difference in the ratio of hormone levels can be used to allocate patients with varicocele on degrees of severity: I-I degree - the ratio of the levels of testosterone and estradiol in the elbow Vienna and testicular Vienna exceeded less than 50 times, (II-I degree - concentration exceeded 50 to 100 times. III-I severity of varicocele - concentration of sex hormones in the veins Lutovinovo plexus exceeded 100 times or more. The most significant levels of the male hormone testosterone and the female - estradiol. Progesterone is less informative, because its concentration is increased during pregnancy and in men its products are unstable. The highest level of sex hormones, the authors noted in samples of blood from veins Lutovinovo plexus (more than 100 times)less than high he was in the Assane extended kremastinou Vienna (about 15 times). For example, the level of estradiol in the blood testicular vein was higher than normal blood levels in pregnant women. As you know, essential in the development of varicose veins in young women is a hormonal link. During pregnancy the hormones yellow body reduces the tonus of smooth muscles of the veins, resulting in increased pressure in the inferior Vena cava and in the veins of the lower extremities increases the hydrostatic factor and varicose disease progresses (Tsarfis p. g Forces of nature, the mind of the doctor: Textbook. manual. - M.: Higher. HQ., 1989. - 144 C.). This proves that the origin of varicose defeat of Vienna, the great value has a direct impact on the wall of the vein higher than normal levels of sex hormones, primarily female (estradiol, progesterone), which provide in a woman's body increased blood flow to the pelvic organs and mammary glands. The emergence of such high concentrations of female sex hormones in the male body, even at some local area of the venous system (veins Lutovinovo plexus), does not go unnoticed and causes first a pronounced enlargement of the veins in this area (up to 3-5 mm wide, according to the U.S.), their tortuous course through the lengthening of Vienna, and then varicose rebirth due to degeneration of the muscular layer. Undoubtedly, an important factor on especiauy stagnation of venous blood in the veins Lutovinovo plexus is the hydrostatic factor, i.e. poor blood flow through testicular vein. The data obtained for the study of level of sex hormones in the serum of patients with varicocele allow us to judge the degree of impairment of blood flow in the veins Lutovinovo plexus and thereby to determine the stage of disease (I-I degree - concentration exceeded less than 50 times, (II-I degree - concentration exceeded 50 to 100 times. III-I severity of varicocele - concentration of sex hormones in the veins Lutovinovo plexus exceeded 100 times or more). When detecting the difference between the concentration of sex hormones in the blood serum of a patient more than fifty times or more, it is shown operative surgical treatment The claimed method is as follows. Perform venipuncture or venesection Vienna Lutovinovo plexus on the left, take this to 1 ml of blood from the affected vein (with straining effort of the patient, for simulation of venous stagnation in a retrograde reflux of blood in the presence of varicocele.) The blood from a vein can also relax during surgical interventions for varicocele podpichovat access Marmara, either during angiographic studies testicular vein crasmareanu access. In parallel, during the same time period, within 5 min, produce affected by the blood from a vein of the elbow bend of the same patient. Samples of blood of a patient with varicocele centrifuged. To study the influence of level of sex hormones on varicocele conduct a comparative study of the levels of hormones in the blood, flowing through my veins Lutovinovo plexus of the left testicle. The study of hormones perform using automatic detection hardware method electrochemiluminescence. Serum concentration is determined both male and female sex hormones (testosterone, estradiol, progesterone). Measure the ratio between the levels of each of the sex hormones in peripheral blood serum and blood, flowing from the testis by varicose veins. On the basis of the relationship of sex hormones in two different points of blood sampling, primarily testosterone and estradiol, determine the presence of varicocele and its degree of severity, such as the stagnation of venous blood in the veins Lutovinovo plexus. The invention is illustrated by the following examples. Example 1. Patient C'th Alexander, age 13 (born 04.05.95,), Marmara (subinguinal ligation Lutovinovo plexus) about varicocele on the left of the III century With the aim of studying the influence of level of sex hormones on varicocele was a comparative study of hormones in the blood flowing through the vessels of the left testicle and from a vein of the elbow bend. During the operation p is about varicocele by way of Marmara, stages were isolated dilated veins of the two main venous pools - kremastinou pool and testicular veins. Blood sampling for determination of hormones was carried out simultaneously from the cubital vein and veins of the left spermatic cord. The study of hormones was performed using an automatic measuring apparatus Elecsis 2010 method electrochemiluminescence. The following results are obtained (sm)
A significant difference between the level of hormones in the peripheral blood and the blood flowing from the testis by varicose veins. The level of serum testosterone blood from a vein Lutovinovo plexus exceeded the normal level of testosterone in 282 times, the level of estradiol in 138 times, and the progesterone level 13 times. The values of the gonadotropic hormones FSH (follicle stimulating hormone) and LH (luteinizing hormone) almost unchanged. Given the proposed gradation, the patient confirmed the diagnosis of a varicocele stage III. Examined on call. No complaints. Relapse no. Example 2. Sick H s AA, 17 years old (born 23.03.91,), Marmara (subinguinal ligation Lutovinovo plexus) about varicocele on the left of the II-III century With the aim of studying the influence of level of sex hormones on varicocele was a comparative study of hormones in the blood flowing through the vessels of the left testicle and from a vein of the elbow bend. During the operation for varicocele by way of Marmara (microsurgical varicocele), conducted a blood sample for the determination of hormones, at the same time from the cubital vein and veins of the left spermatic cord. The study of hormones conducted using automatic detection on and the apparatus Elecsis2010 method electrochemiluminescence. The following results are obtained (see table 2)
Noted a significant difference between the levels of sex hormones in the peripheral blood and the blood flowing from the testis by varicose veins. At the same time, the level of LH is not significantly changed, on the contrary, showed a slight decrease in the blood, flowing from the testis. The level of testosterone serum differed in 101 times, the level of estradiol - 50 times. Patient invoice is MS postoperative diagnosis of varicocele stage II. Examined on call in the remote period after the operation. No complaints. Relapse no. For comparison was performed blood sampling in patients without varicocele (with inguinal hernia, hydrocephalus shells, egg, cyst of the epididymis and spermatic cord). In this group of patients the difference between the level of sex hormones in the veins Lutovinovo plexus and in the elbow Vienna (samples taken simultaneously at one and the same patient during the surgical intervention open access) does not exceed 10 times the level. Example 3. Patient R s A., age 17, the operation of Winkelman right about dropsy membranes of the egg to the right. The patient was a comparative study of hormones in the blood flowing through the vessels of the right testis and from a vein of the elbow bend. During the operation about dropsy of shell eggs held blood sampling for determination of hormones, at the same time from the cubital vein and veins of the left spermatic cord. The study of hormones was carried out using an automatic measuring apparatus Elecsis2010 method electrochemiluminescence. The following results are obtained (see table 3).
When studying the difference in the level of sex hormones, taken from Lutovinovo plexus on the right and the ulnar vein, significant differences are not observed. Diagnosis: right dropsy of the shells of the eggs. Example 4. Patient-to VI, 29 years of operation - gryzhesechenie right about the right-sided inguinal hernia. The patient had simultaneous comparative study of hormones in the blood flowing through the veins of the right testis and from a vein of the elbow bend. During the operation conducted blood sampling for determination of hormones, at the same time from the cubital vein and veins of the right spermatic cord (Lutovinovo plexus). The study of hormones was carried out using an automatic measuring apparatus Elecsis2010 method electrochemiluminescence. The following results are obtained (indicators of sex hormones shelter the patient (see table 4).
When studying the difference in the level of sex hormones, taken from Lutovinovo plexus on the right and the ulnar vein, the differences of level, exceeding through the veins Lutovinovo plexus, no more than 10-fold. The level of testosterone in the blood serum was 10 times the level of estradiol - 6.3 times, and the level of progesterone - 1.9 times. The level of female sex hormones in the veins Lutovinovo plexus did not reach the normal range in women, which eliminates their pathological effects on the venous wall. Diagnosis: prostora the inner inguinal hernia. Example 5. Patient A., 16 years old, sick varicocele for 4 years, moved six months ago surgery about a left-sided varicocele III senior laparoscopic occlusion of the testicular veins to the left. In the postoperative period was noted for the preservation of varicose veins Lutovinovo plexus, originally spachina veins were again filled, resumed moderate discomfort after exercise. When an ultrasound revealed regurgitation of blood through the veins of the spermatic cord to the testicles, enlargement of the veins of 0.3 to 0.4 cm Suspected disease recurrence. The patient had an operation Marmara (subinguinal ligation Lutovinovo plexus) about recurrent varicocele on the left of the I-II century Was a comparative study of hormones in the blood flowing through the vessels of the left testicle and from a vein of the elbow bend. During the operation conducted blood sampling for determination of hormones, at the same time from the cubital vein and veins of the right spermatic cord. The study of hormones was carried out using an automatic measuring apparatus Elecsis2010 method electrochemiluminescence. The following results are obtained (see table 5). td align="justify"> The result from Vienna Lutovinovo plexus
The marked difference between the levels of sex hormones, peripheral blood, flowing from the testis by varicose veins. The level of testosterone serum differed in 115,64 times, the level of estradiol in 51,5. The patient exhibited postoperative diagnosis of varicocele stage II. To identify the boundaries of severity were examined 36 patients with varicocele varying degrees of severity, starting with the first (5 patients), second degree (15) to the third (12 people), as well as with recurrent varicocele (4 patients). The degree of varicocele was installed previously on the basis of the years of clinical classifications, and with the help of ultrasound. In addition, the control group consisted of patients (5) with right-sided disease of the testis (inguinal hernia, hydrocephalus shells, egg, cyst of the epididymis and spermatic cord). The obtained data allowed to identify certain patterns of concentration levels of sex hormones, depending on the severity of varicocele, which was the basis of the proposed method. Thus, the major difference of the proposed method are: 1. The use of blood sampling by venesection or venipuncture Vienna Lutovinovo plexus of the left testicle, with straining effort of the patient, for simulation of venous stagnation in a retrograde reflux of blood in the presence of varicocele. 2. For the first time to determine the severity of varicocele and confirm the diagnosis of varicocele is used determine the level of sex hormones. 3. Using the relationship of the levels of sex hormones in the blood taken from the patient in different parts of the venous system in the localization of the disease and in the typical site of venipuncture (Vienna elbow bend), within 5 minutes 4. Varicocele in men is determined by the concentration not only of the male sex hormone (testosterone)and female sex hormones (estradiol, progesterone) in the veins Lutovinovo plexus of the left testicle and peripheries the Vienna Oh elbow bend of the same patient, this determines the ratio of the levels of sex hormones. Given a set of distinctive features not described in literature. Thus, the claimed invention meets the criterion of "novelty". The comparison of the proposed solutions not only prototype, but other solutions in this field of science has shown that the optimal diagnostic method for identifying the stage of varicocele is a direct comparative measurement of sex hormone levels in testicular and ulnar veins, which can confirm the presence of varicocele, to identify the severity of varicocele, plan treatment policy. There were signs that distinguish the claimed method, allow to conclude that compliance with a criterion of "inventive step". The method does not allow for radial load, is not expensive, is in the process of surgical intervention on spermatic cord and does not require additional invasive access. Detected increased levels of hormones (fifty or more) can serve as a diagnostic confirmation of varicocele recurrence after surgery or roentgenologically interventions laparoscopic occlusion of testicular veins. There is a high informative way to diagnose the stage of varicocele in combination with safety for the patient. The easy way in which proizvodi as in the hospital, and in clinics, outpatient diagnostic center. Sources of information 1. Nechiporenko AS "ON the classification and treatment of varicose veins of the spermatic cord". // Urology. - 1964. No. 2. - P.28-32. 2. Tiktinsky O.L., Mikhailichenko CENTURIES Andrology. - SPb.: Media Press, 1999. - pp.261. 3. Clinical endocrinology: a Guide / edited NetStorage, M.: Medicine, 1991. - S-415. 4. RF patent №2177727 C2. 2002.01.10. Method for the diagnosis of recurrent varicocele. 5. RF patent №2231289 C2. 2004.06.27. Method for the diagnosis of partial age-related androgen deficiency (PADAM). 6. White SR, Galeev, BC, Safin G.M. "Phlebography varicocele". Kazan medical journal, 1988, No. 3, s-175. Century "Venography in the diagnosis of varicose veins of the spermatic cord". Bulletin of radiology, 1988, No.1, p.47-49. 7. The tsarfis p. g Forces of nature, the mind of the doctor: Textbook. manual. - M.: Higher. HQ., 1989. - 144 S. 1. The way to diagnose the severity of varicocele and its recurrence, including the exploration of Vienna Lutovinovo plexus of testicular left at natureway patient, characterized in that conduct blood sampling simultaneously in the peripheral Vienna elbow bend and in Vienna Lutovinovo plexus of the left testicle of the patient, determine the level of sex hormones: testosterone, estradiol, progesterone, and when soothes the research Institute of the level of sex hormones in healthy Vienna elbow bend to their level in affected due to varicocele Vienna Lutovinovo plexus of the left testicle from 1:10 to 1:50 diagnosed with first degree varicocele, at the specified ratio of a level of hormones from 1:50 to 1:100 diagnosed with second degree varicocele, with a ratio of more than 1:100 diagnosed with third degree varicocele. 2. The method according to claim 1, characterized in that the blood is carried out by venesection or venipuncture Vienna Lutovinovo plexus of the left testicle, with straining effort of the patient, or by compression of the proximal portion of the vein to simulate venous stagnation in a retrograde reflux of blood in the presence of varicocele. 3. The method according to claim 1, characterized in that the blood of both veins should be performed within no more than five minutes. 4. The method according to claim 1, characterized in that the ratio of sex hormone levels less than ten times diagnose the absence of varicocele. 5. The method according to claim 1, characterized in that the ratio of the levels of sex hormones more than 1:50 showing a prompt surgical intervention about varicocele.
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