[Infection of the lower urinary tract: new possibilities of herbal medicine].

The review article is devoted to using modern combined herbal remedies for the treatment and prevention of urinary tract infections. From current point of view, the mechanisms of the pharmacological action of the components of Phytolysin preparations, paste for the preparation of a suspension for oral administration and Phytolysin capsules, are described in detail. The pathogenetic explanations of using herbal preparations in urological patients is given. The results of clinical studies are presented, confirming the efficiency of the use of drugs for the treatment and prevention of lower urinary tract infections. The new dosage form Phytolysin in the form of capsules does not differ in composition from the paste. Pharmacological effects and pathogenetic bases for the use of Fitolizin suggest that the new dosage form (capsules) is identical to the traditional, previously used one (paste).

[Recurrent lower urinary tract infection in women: treatment and prevention].

INTRODUCTION: Antibiotics represent the main drugs for the treatment and prevention of recurrent lower urinary tract infections (UTIs). At the same time, there is no consensus regarding the duration of therapy and the interval between courses. MATERIAL AND METHODS: A total of 50 women aged 18 to 65 years (mean age 44.6+/-13.2 years) with recurrent lower UTIs in the acute stage were treated. All patients were prescribed fosfomycin trometamol (Fosfomycin Esparma, Esparma GmbH, Germany) at a dose of 3 g once every 10 days for 3 months. The changes of clinical and laboratory parameters were evaluated on the 3rd day after the first administration of fosfomycin, and then after 1, 3 and 6 months from the start of treatment. RESULTS: A decrease in the severity of clinical manifestations of cystitis was seen on the next day after first administration of fosfomycin. By the 3rd day, the ACSS score decreased from the initial 9.2+/-2.1 to 1.4+/-1.0 (p<0.001), while the average urinary frequency changed from 12.3+/-2.3 to 7.5+/-1.4 (p<0.05). After 3 months of therapy, the clinical results virtually did not differ from results on the 3rd day. The therapy was well tolerated; adverse events were noted in 10 patients, but they didnt result in discontinuation of the drug. During follow-up for 3 months after the completion of therapy, 47 (94%) women didnt have recurrence of lower UTI. CONCLUSION: the results of the study suggest a high efficiency and good tolerability of fosfomycin when it is prescribed according to specific scheme for the treatment and prevention of recurrent lower UTIs in women.

[D-mannose for prevention and treatment of lower urinary tract infection: pathogenetic basics and clinical results].

Non-antibacterial methods of prevention and treatment of lower urinary tract infection are described in the article. The current view on the mechanism of treatment effect of D-mannose is presented, which contributes to the prevention of bacterial invasion. Pathogenetic concepts for using D-mannose as specific antiadhesin or a competitive blocker of bacterial invasion is provided. In addition, we discussed the results of basic and clinical studies, proving the efficiency of D-mannose for prevention and treatment of lower urinary tract infection.

[Bladder hydrodistension in treating patients with interstytial cystitis/ bladder pain syndrome].

This study aimed to evaluate the effectiveness of bladder hydrodistension in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), depending on the duration of the procedure. MATERIALS AND METHODS: The study comprised 71 women aged 51.6+/-8.3 years with a 5.2+/-2.3 year history of IC/BPS. All patients underwent bladder hydrodistension (BH). Depending on the duration of BH, patients were divided into 4 groups. The distension time in group 1 (n=10), group 2 (n=20), group 3 (n=20) and group 4 (n=21) was 1 min, 2 min, 4 min and 6 min, respectively. The treatment effectiveness was assessed 1 month after BH by subjective assessment of patients, Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale questionnaire, a visual analog pain scale (VAS), and voiding diaries. RESULTS: At one month after BH, positive effect was observed in 32 (45.1%) patients. In groups 1, 2, 3 and 4 the treatment was effective in 20%, 55%, 45% and 47.6% of patients, respectively. Clinical effectiveness of BH with distension time of 1 min was significantly lower than that of 2, 4, and 6 min. At the same time, we did not find significant differences in the effectiveness of this procedure with distension time of 2, 4 and 6 min. CONCLUSION: The results of this study suggest that BH is an effective treatment in patients suffering from IC/BPS. At the same time, they show that the distension time of 2 min. is optimal from the point of view of clinical effectiveness, since the longer duration of the procedure is excessive, and the shorter time is insufficient.

[URINARY DISCOMFORTS IN PATIENTS AFTER RADICAL PROSTATECTOMY].

The authors showed the result of complication treatment of lower urinary tracts in 128 patients with localized prostate cancer. The patients underwent radical prostatectomy. Urinary discomforts included enuresis, urinary incontinence in postoperative period. Abnormalities of urine outflow due to urethral stricture were revealed in 6 (4,6%) patients by the 6 month after operation. These complications required surgical treatment. Urinary incontinence was noted in 20 (15,6%) patients in this period. It was stressful urinary incontinence in 16 (12,6%) and urgent - in 4 (3%). Patents with stressful urinary difficulty were advised to use the conservative treatment (pelvic floor muscle training and electrostimulation), but in case of inefficiency - surgical treatment.

[Combined treatment of genital human papillomavirus infection in men].

This study aimed to assess the efficacy of treatment of genital human papillomavirus infection in 107 men. Patients in group 1 (n=51) underwent laser ablation of genital warts, patients in group 2 (n=56) were treated with laser ablation in conjunction with the administration of an immune system medication izoprinozin. During the first 9 months post-treatment, human papillomavirus infection relapse rate in group 1 was 23,5% and in group 2 - 5,4%. It was likewise observed that the combined treatment of genital warts resulted in reduced incidence of infective complications and the time of wound epithelialization after laser papilloma ablation.

[Changes of rat respiratory and locomotory muscles during aerobic exercise training in continuous and interval regimens].

Male Wistar rats were treadmill-trained for 8 weeks using one of the two regimens: with the constant running speed or with alternating high-speed and low-speed intervals. Both training regimens led to an increase of rat aerobic capacities and to a higher citrate synthase activity in the medial head of gastrocnemius muscle. No differences between the effects of two training regimens were observed. However, in contrast to constant-speed training the interval one resulted in myocardium hypertrophy and also in less pronounced changes in diaphragm muscle, such as slow-direction shift of myosin phenotype and reduction of muscle fiber cross-sectional area. Neither of the training regimens had an effect on corticosterone and thyroid hormones levels in rat blood, whereas the interval training resulted in a higher level of testosterone. Anabolic influence of testosterone during interval aerobic training may be favorable for heart hemodynamic capacity and force characteristics of the diaphragm.

[Comparative analysis of gene expression in rat locomotor muscles and diaphragm].

Gene expression profile in diaphragm in comparison to three principally different hindlimb muscles (soleus, red and white gastrocnemius) was studied using quantitative PCR. Expression levels of PGC-1alpha mRNA and myogenin mRNA in diaphragm were in accordance with its myosin phenotype and citrate synthase activity. However, diaphragm was characterised by atypically high content of MyoD mRNA as well as high content of IGF-1 mRNA and low content of myostatin mRNA. The latter two findings suggest high intensity of protein synthesis in diaphragm muscle fibers, although they have smaller cross sectional area than fibers in locomotor muscles.

[Transcriptional analysis of the Grp gene, a genomic homolog of the retrotransposon gypsy gag gene, in Drosophila melanogaster].

In the present work, we studied the Grp gene (CG4680, Gag related protein) expression at the transcriptional level. It was found that at the embryonic and larval stages of D. melanogaster development the Grp expression proceeds at a low level, but it significantly increases at the adult stage. Adult individuals display a tissue-specific expression: an eleveated level of transcription is observed in the gut tissues, but not in the chitin carcass, head, and gonads. Since the gut may potentially be a primary barrier for the penetration of a viral infection, we conducted a comparative analysis of Grp gene transcription in D. melanogaster strains differing in the presence of active copies of the gypsy errantivirus and in the status of the flamenco gene controlling sensitivity to errantiviral infections. No noticeable differences in the level of Grp gene transcription were revealed. Thus, the Grp gene is not a pseudogene, but it is a functional gene of the D. melanogaster genome whose role remains to be elucidated.

[Soft tissue chondroma].

The paper gives a rare case of soft tissue chondroma in a 55-year-old female woman who has unsuccessfully received physiotherapeutic procedures for more than 6 months due to misdiagnosis. The patient detected the tumor herself. Clinical and X-ray diagnostic difficulties are considered. Differential diagnosis was made between synovial chondromatosis and chondrosarcoma. A correct diagnosis could be established only at open tumor biopsy. The neurovascular fascicle, tendons, and an intrinsic group of shoulder muscles could be preserved during radical surgery. The problems in the morphological diagnosis of extraskeletal chondroma are discussed in detail. The results of organ-preserving resection are presented.

[Dedifferentiated chondrosarcoma: problems of diagnosis and treatment].

In 2001-2007, Moscow cancer hospital sixty-two examined 77 patients with chondrosarcoma (including consultative cases). The dedifferentiated form of the tumor was confirmed in 10 (13%) cases. Recurrences and metastases were observed in 3 patients. Radical surgery could be performed in 5 patients, including interileoabdominal exarticulation in 4 patients. Immunohistochemical studies provide a way of specifying the nature of one of the tumor components. Ultrastructural data on the components of dedifferentiated chondrosarcoma are first presented in the Russian literature. Fine-needle biopsy and trepan-biopsy may give an incorrect guide to choosing treatment policy. The experience in performing combined therapy for this unusual tumor is first presented in the Russian literature and drug pathomorphism has been studied. Radical surgery remains to be the method of choice in treating patients with dedifferentiated chondrosarcoma; however, the capabilities of multidrug therapy and irradiation should not be ignored in this form of the tumor.

[Abnormal (bizarre) paraostial osteochondromatous proliferation (Nora's disease)].

Bizarre paraostial osteochondromatous proliferation (BPOP) is a reactive process composed of bone and cartilage attached to the surface of a bone, the condition was first described by Nora et al. as a reactive proliferation involving small bones. A case of a 76-year-old male represents the first description of BPOP in the Russian literature. The patient has a history of trauma, the duration of symptoms being more than a year. Xray study shows suspected secondary chondrosarcoma. The benign space-occupying lesion BPOP is verified after wedge resection of the phalanx. The described condition seems to occur more frequently than reported in the literature. Current imaging techniques and histological study permit avoidance of diagnostic errors and correct choice of the scope of treatment.

[Osteochondrosarcoma: clinical and morphological comparisons].

A total of 109 patients with chondrosarcoma were operated on in 2005-2007. Classical primary chondrosarcoma was verified in 77 cases; secondary and periosteal chondrosarcomas were confirmed in 28 and 4 patients, respectively. By analyzing their findings and the data available in the literature, the authors considered the current problems in the classification and diagnosis of the most common types of cartilaginous malignancies. New techniques, including cytogenetic assay, significantly alleviate this problem. However, the most precise cytogenetic assays are expensive and not always accessible for usual oncological care. The principal criteria in practice are a clinical picture, the results of radiation studies, and the standard histological method that establishes the differentiation of chondrosarcoma, the extent of a process, and the specific features of tumor growth. Immunohistochemical assay are of no crucial importance. In some cases, fine-needle biopsy may provide useful information to make a decision on treatment policy.

[Ossifying fibromyxoid tumor].

Ossifying fibromyxoid tumor (OFMT) is a rare tumor of unknown histogenesis. It consists of chains and trabecules of ovoid cells in the fibromyxoid stroma (ICD code 8842/0). Tumor is frequently surrounded in part by a capsule of laminar bone. It is more frequent in males 14-79 years of age, mean 44 years. Soft tissues of extremities is a preferable location, but body, neck, oral cavity, mediastinum and retroperitoneal tissue can also be the site of OFMT. More than 100 OFMT cases are reported abroad. It is frequently masked by other tumors of soft tissues. We describe 3 cases in our country: 2 in 65 and 66 year old females and in a 44 year old male. Lipoma and soft tissue sarcoma were suspected clinically. Fibroblasts were found cytologically before operation in one case. Diagnosis was established after total biopsy of the tumor. One of the females is under observation after the operation without recurrence during more than two years. Preoperative diagnosis is sometimes possible when characteristic osteoblastic foci are observed.

[Gangliocytic paraganglioma of the duodenum].

Gangliocytic paraganglioma in a female of 64 years of age with stones in the gall bladder, atrophic liver cirrhosis and gastro-intestinal polyposis is described in the Russian literature for the first time. Polyps of the rectum and sygmoid were removed within 15 years. The same pathology was described by other authors. It is possible that the occurrence of paraganglioma and polyps was of genetical nature. The tumor was detected at gastroduodenoscopy. Biopsy diagnosis varied from polymorphocell liposarcoma and malignant fibrous histiocytoma. Endoscopic tumor electroexcision was complicated by intestinal bleeding that followed by an urgent laparatomy, duodenotomy and suture of the bleeding vessel in the duodenal wall. Bleeding zone in the duodenum was 3 cm from papilla Vateri. Analysis of difficulties in clinical and morphological differential diagnosis is performed.

[Adamantinoma of long tubal bones].

Four cases of adamantinomas of the long tubular bones, ulna and femur among them which rarely occur in patients aged 18-64 years (one female) are reported. A late metastasis to the sacrum was observed in one case. Typical diagnostic errors are described. Electron microscopy data are provided. Immunohistochemistry helps in differential diagnosis of this tumor. Histology does not give too much for the prognosis, radical resection does not influence the incidence of recurrences and metastases. The surgeons should be warned against enucleation of the tumor.

[Prostatilen treatment of prostatic adenoma].

We studied efficacy of repeated courses of prostatilen in suppositories with dimexide in prostatic adenoma patients with normal micturition. Rectal suppositories contain 30 mg prostatilen and 90 mg dimexide. The course consisted of 15 suppositories. The treatment reduced clinical symptoms of infravesical obstruction, residual urine volume in administration of prostatilen in 15-day courses each 3 months. This suggests possibility of suppository prostatilen use not only as an alternative for expensive drugs but also in combination with them in treatment of initial prostatic adenoma.

[Prostatilen effects on voiding disorders in patients with benign prostatic hyperplasia].

The authors review the experience with prostatilen treatment gained in the urological clinic of the St-Petersburg State Medical University and analyze treatment outcomes for 96 patients with benign prostatic hyperplasia (BPH) aged from 51 to 89 years. Prostatilen proved its efficacy in relieving manifestations of infravesical obstruction in BPH, therefore, prostatilen administration in the treatment of patients with initial or moderate subjective and objective symptoms is justified. Dimexide suppositoria containing 30 mg of prostatilen are preferable.

[Extraovarian malignant Brenner tumor]. / Ekstraovarial'naia zlokachestvennaia opukhol' Brennera.

Extraovarian malignant Brenner tumour in a female of 35. Rapid infiltrating growth with the destruction of tumour. All extraovarian tumours described so far were benign, located in the mesosalpinx, uterus or vagina. In this case the starting point of the tumour was in the vagina wall or in the recto-vaginal septum. Histological picture produced difficulties in establishing histogenesis of malignancy. The true nature of the tumour was established only immunohistochemically.

[Our experience in the use of prostatilen in urology]. / Nash opyt primeneniia prostatilena v urologii.

Prostatilen was used in 1115 patients with chronic pyelonephritis and prostatitis. It is shown that prostatilen has a corrective effect on hemocoagulation and immunity disorders, restores microcirculation, suppresses inflammation in the kidney and prostate. Thus, prostatilen is a pathogenetically sound drug for treatment in urogenital inflammation while in chronic prostatitis it can be used as a basic therapy.