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1518: The Role of Ultrasonography in Selecting Chronic Prostatitis Patients for Keishibukuryogan (Kampo Medicines)
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Ultrasound in Medicine and Biology
Purpose: To explore the value of ultrasound contrast agent Sonovue and cadence contrast pulse sequencing technology(CPS,Siemens)in renal mass lesions. Methods: 361 suspected renal occupied lesions underwent conventional and contrast-enhanced ultrasound examinations. Equipment: Sequoia512; contrast agent: 0.8ml ⬃ 1.2ml Sonovue; injection mode: 5ml 0.9% NaCl injection just after bolus injection of Sonovue via peripheral vein. To assess the perfusion time and its characteristic of the agent,the results were compared with that of pathology. Results: In the 361 lesions, 275 lesions were diagnosed as malignant: 216 lesions presented with fast and high enhancement in cortex phase, 37 with slow enhancement, 22 with iso-enhancement; 69 with quick wash-out, 167 with slow wash-out, 39 with iso-wash-out. 86 lesions were diagnosed as benign: periphery of the 18 lesions presented with fast enhancement in renal cortex phase, 26 with slow enhancement, 21 with inhomogenous enhancement, 21 with no enhancement. Pathology Results: Malignant 252, benign 109 clear cell carcinoma 210 , clear cell sarcoma 3, squamous cell carcinoma 4, multilocular cystic renal carcinoma 3 , papillary renal cell carcinoma 10,chromophobe carcinoma 8,granular cell carcinoma 3, Bellini carcinoma 2,metastatic carcinoma 5, non-Hodgkin⬘s limphoma in 4. The accuracy,sensitivity,and specificity were 91.6%(252/275), 78.8%(86/109), 94.0%(361/384), respectively. Conclusion: The contrast-enhanced ultrasound has significant value in the differential diagnosis of the renal mass lesions. 1515 Clinical use of Hand-Carried Ultrasound Devices for Ureteral Stone Detection Toru Kameda, Japan Objective: To evaluate the usefulness of hand-carried ultrasound (HCUS) devices for ureteral stone detection. Materials and Methods: Between September 2004 and October 2006, HCUS was performed by the author in 64 patients clinically suspected of having ureterolithiasis in the emergency department of an urban teaching hospital. Of the 64 patients, 47 diagnosed to have ureterolithiasis by urologists on a following day were enrolled in this study. The examination was performed by using one of two HCUS devices: LOGIQ BooK XP (GE Medical Systems), SonoSite 180PLUS (SonoSite). At first both of the kidneys were observed with HCUS to evaluate the intrarenal collecting systems. Thereafter, the possible course of the ureter and the bladder were searched to find the stone. Results: The ureteral stone was detected with HCUS in 16 (34%) of the 47 patients. The locations included the ureteropelvic junction (n ⫽ 3), the proximal ureter (n ⫽ 1) and the ureterovesical junction (n ⫽ 12). The bladder was distended in 37 of the 47 patients. The stone was detected in 16 (43%) of the 37 patients. Conclusion: It is helpful to search for a ureteral stone with HCUS for the conformation of ureterolithiasis when the bladder is distended. 1516 Urinary Bladder: Another Region of Focus During Transrectal Ultrasonography Hyoung Jun Kim, Kyng Hee University Medical Center, Korea Joo Won Lim, Kyng Hee University Medical Center, Korea Dong Ho Lee, Kyng Hee University Medical Center, Korea Young Tae Ko, Kyng Hee University Medical Center, Korea Purpose: Transrectal ultrasonography (TRUS) has been used as an imaging modality for evaluating the prostate rather than the urinary bladder. This study was designed to assess the feasibility of TRUS for detecting bladder lesions.
Volume 35, Number 8S, 2009 Materials and Methods: TRUS images of 979 consecutive patients were retrospectively reviewed with respect to the bladder abnormality. Only 327 patients out of 979 were enrolled in the study. These 327 patients underwent other imaging modalities within adequate time interval, to confirm the findings of TRUS. Other imaging modalities consist of intravenous pyelography, cystourethrography, abdominal ultrasonography, MDCT, and MRI. Results: Twenty two patients had abnormal finding in bladder on TRUS. In 21 patients out of 22, the findings on the other examinations were consistent with those on TRUS. In one patient, abnormal finding was not found in other imaging modality. In 305 patients, abnormal finding was not present in bladder on TRUS. In 23 patients out of 305, abnormal finding was present in other imaging modalities. TRUS showed the high specificity (99.6%) and the low sensitivity (47.7%). Conclusion: Our study showed the high specificity and the low sensitivity of TRUS in detecting urinary bladder lesions. In conclusion, we suggest that examiners should be careful not to overlook any abnormality of the urinary bladder during TRUS. 1517 Roles of Color Doppler Imaging During Transrectal Ultrasonography: Pictorial Review Hyoung Jung Kim, Kyng Hee University Medical Center, Korea Joo Won Lim, Kyng Hee University Medical Center, Korea Dong Ho Lee, Kyng Hee University Medical Center, Korea Young Tae Ko, Kyng Hee University Medical Center, Korea Background: Transrectal ultrasonography (TRUS) examinations have been applied in the prostate, urinary bladder, and distal ureter. During TRUS, color Doppler imaging (CDI) has been used as an adjunct to the conventional gray-scale ultrasonography for improving the accuracy of prostate cancer detection, especially for isoechoic cancers. In addition to the prostate cancer, CDI may also provide important information in the diagnosis of various diseases in prostate, urinary bladder, and distal ureter. Purpose: The purpose of this exhibition is to provide pictorial review of the CDI during TRUS in various disease of the prostate, urinary bladder, and distal ureter. Image Findings: This exhibition consists of the followings: introduction / prostatic adenocarcinoma / prostatic transitional cell carcinoma / granulomatous prostatitis / prostatic tuberculosis / acute prostatitis / prostatic abscess / bladder tumor / malignant distal ureteral stricture / benign distal ureteral stricture / summary. Conclusion: CDI may provide useful information in the diagnosis of the various disease of the prostate, urinary bladder, and distal ureter. 1518 The Role of Ultrasonography in Selecting Chronic Prostatitis Patients for Keishibukuryogan (Kampo Medicines) Akira Kimura, Kimura Urology and Skin Clinic, Japan Background: Chronic prostatitis is associated with pelvic pain upon urination and/or ejaculation. In severe cases, patients have pain from such mundane acts as sitting. Keishibukuryogan is one of the effective Kampo medicines to treat patients with static blood. I prescribed Keishibukuryogan, when chronic non-bacterial prostatitis patients were supposed to have static blood. Patients and Methods: During April 2005 to March 2008, 147 patients with chronic pelvic pain lasting more than six months visited my clinic. By the bacteriological examination of prostatic secretion, 138 cases were chronic non-bacterial prostatitis. Patients underwent transabdominal ultrasonography. In 62 cases, enlarged and twisted periprositatic vein were visualized.
Abstracts They were diagnosed as having static blood, and Keishibukuryogan was prescribed, except two cases who had already prescribed Kampo medicines. Among 76 cases without enlarged periprositatic vein, 35 cases with pain reinforced by sitting were diagnosed as having static blood, and Keishibukuryogan was prescribed. Patients who improved and required no farther prescription were classified as success. No reccurence occurred during following six months. Patients who claimed to feel better but ceased seeing me regularly before complete pain relief were classified as improvement. Patients who continued to have the same symptoms were classified as failure. Results: Among 60 patients with enlarged periprositatic vein, 12 were classified as success, 29 as improvement, and 19 as failure. Among 35 patients without enlarged periprositatic vein, 3 were classified as success, 11 as improvement, and 21 as failure. Conclusion: By detecting enlarged periprositatic vein, ultrasonography was useful to choose patients to prescribe Keishibukuryogan. 1519 Expression and Clinic Value of HOXB13 in Prostate Cancer Yanmi Li, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Jie Tang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Jingchun Yang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Xiang Fei, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Shunxin Zhang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Li Xu, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Background: PCa is a major cause of suffering in males. There have been attempts to identify genes that might be involved in prostatic development and carcinogenesis. HOXB13 is the last identified vertebrate HOX gene. This research was carried out to evaluate the expression of HOXB13 in PCa by real-time PCR, and investigate the correlation with clinical values. Methods: Transrectal CEUS was carried out in twelve individuals who were demonstrated to be PCa by subsequent transrectal ultrasound (TRUS) biopsy. With the quantifying analysis software-Autotracking Contrast Quantification (ACQ), the arrival time (AT), time to peak intensity (TTP) and peak intensity (PI) of regions of prostate cancer were evaluated. TRUS-guided biopsies were performed in the region of cancer and non-cancer, respectively. With real-time quantitative PCR, the amplification curve and melting curve were obtained. The relationships between the expression of HOXB13 and the level of PSA, AT, TTP and PI were analyzed, respective. Results: The mean threshold cycle (Ct) of cancer tissue were (14.45⫾ 0.94) and non-cancer tissue were (15.86 ⫾ 0.67), P⬍0.05. There were statistically correlations between expression of HOXB13 and tPSA (r⫽0.591, P⬍0.05). But there were no statistically correlations between expression of HOXB13 and fPSA (P⫽0.135), or and fPSA/tPAS (P⫽0.123). In prostate cancer tissue, there were statistically significant correlations between Ct and AT (r⫽0.652, P⬍0.05), no correlation between Ct and TTP (P⫽0.210) or PI (P⫽0.053). Conclusions: HOXB13 was more abundant in the prostate cancer tissue than prostate non-cancer tissue and the expression was correlated with tPSA, AT. Key words: Prostate; Cancer; HOXB13; transrectal contrast-enhanced ultrasonography.
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1520 Infectious Complications and Treatment in Transrectal Ultrasound-Guided Prostate Biopsies Jie Tang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Yanmi Li, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Xiang Fei, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Jingchun Yang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Shunxin Zhang, Ultrasound Department of South Builing, Chinese People’s Liberation Army General Hospital, China Li Xu, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Yan Zhang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Objective: To investigate the incidence and characteristics of infectious complications following transrectal ultrasound (TRUS) guided prostatic biopsy, based on lab culture, treatment and outcome. Methods: Nine hundred and forty-seven patients who underwent TRUS guided prostatic biopsy in our hospital between Feb. 2005 and Nov. 2008. These patients were treated with 400mg norfloxacin orally twice daily for three days and 400mg arilin three times daily for five days, both beginning 8⬃12h before biopsy. After one month, the patients were assessed regarding their symptomatology and post-biopsy complications. Results: Fifty-three out of these cases presented infectious complications. Fever (⬎37.5°C) was the most common type (36 cases, 3.8%) with the highest temperature of (38.6⫾0.5) °C. They were treated with Quinolone i.v. and arilin orally. After (5.21⫾3.37) days the temperature came to normal. Urinary tract infection occurred in 12 patients (1.3%) and they were treated with Quinolone. Orchitis and epididymitis occurred in three patients. One case was treated with symptomatic treatment and the other two cases were treated with orchiectomy. The presence of prostate cancer is a risk factor for infectious complications (p ⬍ 0.05). Age, the volume of the prostate, PSA, diabetes mellitus, WBC Count and number of samples were not correlated with postbipsy infections. Conclusions: Infectious complications may occure after TRUS guided prostatic biopsy, but it’s very sensitive to Quinolone and arilin. TRUS guided prostatic biopsy still is a safe and effective method for diagnosing prostatic diseases. Keywords: Endosonography; Prostatic diseases; Biopsy, needle; Infection 1521 Influence of Proteolytic Enzymes on Cerebral Hemodynamics in Patients with Chronic Cerebral Ischemia Valery V Efremov, Rostov State Medical University, Russia Nikolai J Nelassov, Russia Vjatcheslav S Sergienko, Rostov State Medical University, Russia Objective: The last data demonstrated positive effect of systemic enzymotherapy on cerebral stroke. The aim of this study was to analyze if enzymes can positively influence cerebral blood flow regulation in patients with arterial hypertension complicated by chronic cerebral ischemia. Methods: 63 patients (age 22 – 63 years) with arterial hypertension and signs of chronic cerebral ischemia underwent transcranial Dopplerography before and after course of basic therapy (1 month). 30 of them (1-st group) were treated additionally with flogenzyme (2 tablets 3 time a day), and 33 (2-d group) – were not treated.
Ultrasound in Medicine and Biology
Purpose: To explore the value of ultrasound contrast agent Sonovue and cadence contrast pulse sequencing technology(CPS,Siemens)in renal mass lesions. Methods: 361 suspected renal occupied lesions underwent conventional and contrast-enhanced ultrasound examinations. Equipment: Sequoia512; contrast agent: 0.8ml ⬃ 1.2ml Sonovue; injection mode: 5ml 0.9% NaCl injection just after bolus injection of Sonovue via peripheral vein. To assess the perfusion time and its characteristic of the agent,the results were compared with that of pathology. Results: In the 361 lesions, 275 lesions were diagnosed as malignant: 216 lesions presented with fast and high enhancement in cortex phase, 37 with slow enhancement, 22 with iso-enhancement; 69 with quick wash-out, 167 with slow wash-out, 39 with iso-wash-out. 86 lesions were diagnosed as benign: periphery of the 18 lesions presented with fast enhancement in renal cortex phase, 26 with slow enhancement, 21 with inhomogenous enhancement, 21 with no enhancement. Pathology Results: Malignant 252, benign 109 clear cell carcinoma 210 , clear cell sarcoma 3, squamous cell carcinoma 4, multilocular cystic renal carcinoma 3 , papillary renal cell carcinoma 10,chromophobe carcinoma 8,granular cell carcinoma 3, Bellini carcinoma 2,metastatic carcinoma 5, non-Hodgkin⬘s limphoma in 4. The accuracy,sensitivity,and specificity were 91.6%(252/275), 78.8%(86/109), 94.0%(361/384), respectively. Conclusion: The contrast-enhanced ultrasound has significant value in the differential diagnosis of the renal mass lesions. 1515 Clinical use of Hand-Carried Ultrasound Devices for Ureteral Stone Detection Toru Kameda, Japan Objective: To evaluate the usefulness of hand-carried ultrasound (HCUS) devices for ureteral stone detection. Materials and Methods: Between September 2004 and October 2006, HCUS was performed by the author in 64 patients clinically suspected of having ureterolithiasis in the emergency department of an urban teaching hospital. Of the 64 patients, 47 diagnosed to have ureterolithiasis by urologists on a following day were enrolled in this study. The examination was performed by using one of two HCUS devices: LOGIQ BooK XP (GE Medical Systems), SonoSite 180PLUS (SonoSite). At first both of the kidneys were observed with HCUS to evaluate the intrarenal collecting systems. Thereafter, the possible course of the ureter and the bladder were searched to find the stone. Results: The ureteral stone was detected with HCUS in 16 (34%) of the 47 patients. The locations included the ureteropelvic junction (n ⫽ 3), the proximal ureter (n ⫽ 1) and the ureterovesical junction (n ⫽ 12). The bladder was distended in 37 of the 47 patients. The stone was detected in 16 (43%) of the 37 patients. Conclusion: It is helpful to search for a ureteral stone with HCUS for the conformation of ureterolithiasis when the bladder is distended. 1516 Urinary Bladder: Another Region of Focus During Transrectal Ultrasonography Hyoung Jun Kim, Kyng Hee University Medical Center, Korea Joo Won Lim, Kyng Hee University Medical Center, Korea Dong Ho Lee, Kyng Hee University Medical Center, Korea Young Tae Ko, Kyng Hee University Medical Center, Korea Purpose: Transrectal ultrasonography (TRUS) has been used as an imaging modality for evaluating the prostate rather than the urinary bladder. This study was designed to assess the feasibility of TRUS for detecting bladder lesions.
Volume 35, Number 8S, 2009 Materials and Methods: TRUS images of 979 consecutive patients were retrospectively reviewed with respect to the bladder abnormality. Only 327 patients out of 979 were enrolled in the study. These 327 patients underwent other imaging modalities within adequate time interval, to confirm the findings of TRUS. Other imaging modalities consist of intravenous pyelography, cystourethrography, abdominal ultrasonography, MDCT, and MRI. Results: Twenty two patients had abnormal finding in bladder on TRUS. In 21 patients out of 22, the findings on the other examinations were consistent with those on TRUS. In one patient, abnormal finding was not found in other imaging modality. In 305 patients, abnormal finding was not present in bladder on TRUS. In 23 patients out of 305, abnormal finding was present in other imaging modalities. TRUS showed the high specificity (99.6%) and the low sensitivity (47.7%). Conclusion: Our study showed the high specificity and the low sensitivity of TRUS in detecting urinary bladder lesions. In conclusion, we suggest that examiners should be careful not to overlook any abnormality of the urinary bladder during TRUS. 1517 Roles of Color Doppler Imaging During Transrectal Ultrasonography: Pictorial Review Hyoung Jung Kim, Kyng Hee University Medical Center, Korea Joo Won Lim, Kyng Hee University Medical Center, Korea Dong Ho Lee, Kyng Hee University Medical Center, Korea Young Tae Ko, Kyng Hee University Medical Center, Korea Background: Transrectal ultrasonography (TRUS) examinations have been applied in the prostate, urinary bladder, and distal ureter. During TRUS, color Doppler imaging (CDI) has been used as an adjunct to the conventional gray-scale ultrasonography for improving the accuracy of prostate cancer detection, especially for isoechoic cancers. In addition to the prostate cancer, CDI may also provide important information in the diagnosis of various diseases in prostate, urinary bladder, and distal ureter. Purpose: The purpose of this exhibition is to provide pictorial review of the CDI during TRUS in various disease of the prostate, urinary bladder, and distal ureter. Image Findings: This exhibition consists of the followings: introduction / prostatic adenocarcinoma / prostatic transitional cell carcinoma / granulomatous prostatitis / prostatic tuberculosis / acute prostatitis / prostatic abscess / bladder tumor / malignant distal ureteral stricture / benign distal ureteral stricture / summary. Conclusion: CDI may provide useful information in the diagnosis of the various disease of the prostate, urinary bladder, and distal ureter. 1518 The Role of Ultrasonography in Selecting Chronic Prostatitis Patients for Keishibukuryogan (Kampo Medicines) Akira Kimura, Kimura Urology and Skin Clinic, Japan Background: Chronic prostatitis is associated with pelvic pain upon urination and/or ejaculation. In severe cases, patients have pain from such mundane acts as sitting. Keishibukuryogan is one of the effective Kampo medicines to treat patients with static blood. I prescribed Keishibukuryogan, when chronic non-bacterial prostatitis patients were supposed to have static blood. Patients and Methods: During April 2005 to March 2008, 147 patients with chronic pelvic pain lasting more than six months visited my clinic. By the bacteriological examination of prostatic secretion, 138 cases were chronic non-bacterial prostatitis. Patients underwent transabdominal ultrasonography. In 62 cases, enlarged and twisted periprositatic vein were visualized.
Abstracts They were diagnosed as having static blood, and Keishibukuryogan was prescribed, except two cases who had already prescribed Kampo medicines. Among 76 cases without enlarged periprositatic vein, 35 cases with pain reinforced by sitting were diagnosed as having static blood, and Keishibukuryogan was prescribed. Patients who improved and required no farther prescription were classified as success. No reccurence occurred during following six months. Patients who claimed to feel better but ceased seeing me regularly before complete pain relief were classified as improvement. Patients who continued to have the same symptoms were classified as failure. Results: Among 60 patients with enlarged periprositatic vein, 12 were classified as success, 29 as improvement, and 19 as failure. Among 35 patients without enlarged periprositatic vein, 3 were classified as success, 11 as improvement, and 21 as failure. Conclusion: By detecting enlarged periprositatic vein, ultrasonography was useful to choose patients to prescribe Keishibukuryogan. 1519 Expression and Clinic Value of HOXB13 in Prostate Cancer Yanmi Li, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Jie Tang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Jingchun Yang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Xiang Fei, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Shunxin Zhang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Li Xu, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Background: PCa is a major cause of suffering in males. There have been attempts to identify genes that might be involved in prostatic development and carcinogenesis. HOXB13 is the last identified vertebrate HOX gene. This research was carried out to evaluate the expression of HOXB13 in PCa by real-time PCR, and investigate the correlation with clinical values. Methods: Transrectal CEUS was carried out in twelve individuals who were demonstrated to be PCa by subsequent transrectal ultrasound (TRUS) biopsy. With the quantifying analysis software-Autotracking Contrast Quantification (ACQ), the arrival time (AT), time to peak intensity (TTP) and peak intensity (PI) of regions of prostate cancer were evaluated. TRUS-guided biopsies were performed in the region of cancer and non-cancer, respectively. With real-time quantitative PCR, the amplification curve and melting curve were obtained. The relationships between the expression of HOXB13 and the level of PSA, AT, TTP and PI were analyzed, respective. Results: The mean threshold cycle (Ct) of cancer tissue were (14.45⫾ 0.94) and non-cancer tissue were (15.86 ⫾ 0.67), P⬍0.05. There were statistically correlations between expression of HOXB13 and tPSA (r⫽0.591, P⬍0.05). But there were no statistically correlations between expression of HOXB13 and fPSA (P⫽0.135), or and fPSA/tPAS (P⫽0.123). In prostate cancer tissue, there were statistically significant correlations between Ct and AT (r⫽0.652, P⬍0.05), no correlation between Ct and TTP (P⫽0.210) or PI (P⫽0.053). Conclusions: HOXB13 was more abundant in the prostate cancer tissue than prostate non-cancer tissue and the expression was correlated with tPSA, AT. Key words: Prostate; Cancer; HOXB13; transrectal contrast-enhanced ultrasonography.
S241
1520 Infectious Complications and Treatment in Transrectal Ultrasound-Guided Prostate Biopsies Jie Tang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Yanmi Li, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Xiang Fei, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Jingchun Yang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Shunxin Zhang, Ultrasound Department of South Builing, Chinese People’s Liberation Army General Hospital, China Li Xu, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Yan Zhang, Department of Ultrasound, Chinese People’s Liberation Army General Hospital, China Objective: To investigate the incidence and characteristics of infectious complications following transrectal ultrasound (TRUS) guided prostatic biopsy, based on lab culture, treatment and outcome. Methods: Nine hundred and forty-seven patients who underwent TRUS guided prostatic biopsy in our hospital between Feb. 2005 and Nov. 2008. These patients were treated with 400mg norfloxacin orally twice daily for three days and 400mg arilin three times daily for five days, both beginning 8⬃12h before biopsy. After one month, the patients were assessed regarding their symptomatology and post-biopsy complications. Results: Fifty-three out of these cases presented infectious complications. Fever (⬎37.5°C) was the most common type (36 cases, 3.8%) with the highest temperature of (38.6⫾0.5) °C. They were treated with Quinolone i.v. and arilin orally. After (5.21⫾3.37) days the temperature came to normal. Urinary tract infection occurred in 12 patients (1.3%) and they were treated with Quinolone. Orchitis and epididymitis occurred in three patients. One case was treated with symptomatic treatment and the other two cases were treated with orchiectomy. The presence of prostate cancer is a risk factor for infectious complications (p ⬍ 0.05). Age, the volume of the prostate, PSA, diabetes mellitus, WBC Count and number of samples were not correlated with postbipsy infections. Conclusions: Infectious complications may occure after TRUS guided prostatic biopsy, but it’s very sensitive to Quinolone and arilin. TRUS guided prostatic biopsy still is a safe and effective method for diagnosing prostatic diseases. Keywords: Endosonography; Prostatic diseases; Biopsy, needle; Infection 1521 Influence of Proteolytic Enzymes on Cerebral Hemodynamics in Patients with Chronic Cerebral Ischemia Valery V Efremov, Rostov State Medical University, Russia Nikolai J Nelassov, Russia Vjatcheslav S Sergienko, Rostov State Medical University, Russia Objective: The last data demonstrated positive effect of systemic enzymotherapy on cerebral stroke. The aim of this study was to analyze if enzymes can positively influence cerebral blood flow regulation in patients with arterial hypertension complicated by chronic cerebral ischemia. Methods: 63 patients (age 22 – 63 years) with arterial hypertension and signs of chronic cerebral ischemia underwent transcranial Dopplerography before and after course of basic therapy (1 month). 30 of them (1-st group) were treated additionally with flogenzyme (2 tablets 3 time a day), and 33 (2-d group) – were not treated.