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Purpose: in vitro study of ultrasound dissection devices' impact on meniscus and knee cartilage as well as comparison of outcomes with familiar arthroscopic techniques.Materials and methods. Meniscus and joint cartilage specimen obtained during total knee replacement were placed in a normal saline. All experiments were conducted no later than in 2 hours after obtaining and followed by histology of biopsy specimens. In the first series of experiment the authors performed meniscus dissection with ultrasound instrument «Scalpel», cold plasm ablator and surgical scalpel.Results. The first series of experiments demonstrated disruption of fibers orientation on meniscus rim after dissection with scalpel; necrosis depth after coblation is 0,7-0,8 mm. Ultrasound dissection devices leave necrosis depth of 0,1-0,2 mm and smooth cartilage surface. The second series of experiments proved that after shaver application cartilage surface was coarse; certain necrosis sections of 16-90 nm were observed on relatively smooth cartilage surface after coblation. Application of ultrasound «Miller» device leaves smooth cartilage surface with no fibers, no signs of cartilage thinning and necrosis not exceeding 15 nm.Conclusion. The results of experiments confirm that use of low frequency ultrasound dissection devices is advantageous as compared to mechanical and ablation cutting techniques while ensuring histologically proven atraumatic handling of biopsy specimens of meniscus and hyaline cartilage.

Research objective: to estimate efficiency of treatment of prostate cancer using high-intensive focused ultrasound on the basis of laboratory analysis of postoperative level prostate-specific antigen (PSA). Objects of research. Objects of research consisted of 110 patients treated in urological clinic of Hospital n.a. S. R. Mirotvortsev (Saratov State Medical University) during the period February, 2009 — March, 2012. Patients took 110 sessions of primary operative treatment of prostate cancer by HIFU therapy method. Technique and research methods. Concentration of PSA in blood changed in all patients every 1,5 month within 6 months after operation, irrespective of its kind (including after repeated HIFU), further — after every 3 month till one year, and later on after 6 months. We were guided by references of the International Consensus, which considers PSA level more than 0,5 ng/ml in blood after 3 months of treatment to be unsatisfactory result. We also headed for PSA level before treatment and oncological risk degree. Results. Median nadir formed 0,5 ng/ml PSA by 3 months after treatment. Patients demonstrated different indicators of PSA dynamics depending on oncological risk, stage and hormonal therapy management. Patients with low oncological risk had initially lower PSA concentration, further PSA concentration reached nadir level faster. At patients with widespread forms of prostate cancer accurate dependence of PSA concentration according to prevalence of process was traced. Time of PSA nadir amount did not differ and was marked as 12-14 weeks on average. At patients received hormonal therapy, lower value of PSA nadir was marked. The conclusion. Monitoring of PSA concentration (PSA nadir by 3 months, dynamics of PSA concentration change) is of great importance in early revealing of relapse after prostate HIFU therapy. High level of PSA nadir and PSA growth according to time period are important prognostic factors.

Increasing interest devoted to technology of high intensity focused ultrasound (high-intensity focused ultrasound, HIFU), basically, is explained by a wide spectrum of potential fields of application at minimum invasiveness of the given method. In oncourology HIFU is applied in prostate and kidney cancer. In case of tumors of renal parenchyma the given technique is being clinically tested, while HIFU is currently used in the practice of European oncourologists in treatment of prostate cancer. The majority of the references describing the results of HIFU application in prostate cancer is based on data of a number of clinical observations. It has been proved that HIFU is a possible method of treatment of highly — and moderate-differentiated tumors, and local relapses after remote radial therapy.