[Comparative assessment of urological, neurological, obstetric, and gynecological risk factors of urinary incontinence in women].

To compare the effects of urological, neurological and obstetricogynecological risk factors of urine incontinence (UI) in women, we made a questionnaire survey covering a representative sample of 4336 female residents of Moscow aged 25-74 years. We used standard epidemiological methods and unified criteria, descriptive statistics and modeling by means of logical regression in 6.12 version of SAS system. We revealed that chronic cystitis and other inflammatory urinary diseases provoke a 4-fold increase in the relative risk (RR) of UI in women being higher than obstetricogynecological risk factors (RR 1.5-2.8) and neurological risk factors (RR 1.3-2.0). UI in many cases is of stress type, but in urinary inflammation a mixed type occurs 1.8 times more frequently. Thus, chronic cystitis and other urinary inflammatory diseases are essential UI risk factors in women.

Female reproductive function in areas affected by radiation after the Chernobyl power station accident.

This paper reports the results of a comprehensive survey of the effects of the accidental release of radiation caused by the accident at the Chernobyl nuclear power station in April 1986. The accident and the resulting release of radiation and radioactive products into the atmosphere produced the most serious environmental contamination so far recorded. We have concentrated on evaluating the outcomes and health risks to women, their reproductive situation, and consequences for their progeny. We have concentrated on two well-defined areas: the Chechersky district of the Gomel region in Belorussia and the Polessky district of the Kiev region in the Ukraine. A number of investigations were carried out on 688 pregnant women and their babies, and data were obtained from 7000 labor histories of the development of newborns for a period of 8 years (3 years before the accident and 5 years after it). Parameters examined included birth rate, thyroid pathology, extragenital pathology such as anemias, renal disorders, hypertension, and abnormalities in the metabolism of fats, complications of gestation, spontaneous abortions, premature deliveries, perinatal morbidity and mortality, stillbirths and early neonatal mortality, infections and inflammatory diseases, neurological symptoms and hemic disturbances in both mothers and infants, trophic anomalies, and biochemical and structural changes in the placenta. Several exogenous, complicating influences were also considered such as psycho-emotional factors, stress, lifestyle changes, and others caused directly by the hazardous situation and by its consequences such as treatment, removal from affected areas, etc.(ABSTRACT TRUNCATED AT 250 WORDS)

Detection of antisperm antibodies on the surface of living spermatozoa using flow cytometry: preliminary study.

OBJECTIVE: To assess the use of flow cytometry (FCM) analysis of living spermatozoa subjected to indirect immunofluorescence staining with the mouse anti-human immunoglobulin (Ig)G monoclonal antibodies (FCM test) as an objective method for the detection of antisperm antibodies in semen and serum. DESIGN: The comparative studies were conducted with the direct and indirect mixed antiglobulin reaction (MAR) and FCM test performed by FCM analyzer FACSCAN (Becton Dickinson Immunocytometry Systems, Mountain View, CA). SETTING: Clinical infertile service. PATIENTS: Seventy-six semen and 20 sera samples of infertile patients were analyzed. RESULTS: For IgG in semen there was a highly significant correlation between the direct MAR and FCM test. Six of 12 IgG-positive samples revealed also IgA, and just one sample, which showed negative MAR, was positive for IgM in FCM test. Flow cytometry test and indirect MAR showed also a highly significant correlation of the results of IgG detection in sera. CONCLUSIONS: Flow cytometry test may be used to verify that IgG antisperm antibodies are on the surface of living spermatozoa either retrieved directly from an ejaculate or after exposure to serum and to determine proportion of antisperm antibodies-positive spermatozoa, titer, and quantity of antibodies bound to the cell surface.

Flow cytometry study on the effect of serum and peritoneal fluid of women on sperm-binding activity of immunoglobulin G antisperm antibodies.

OBJECTIVE: To investigate the influence of sera and peritoneal fluids (PFs) from fertile and infertile women on the binding of antisperm antibodies to the surface of spermatozoa. DESIGN: The immunoglobulin (Ig) G antisperm antibodies binding to the surface of liver spermatozoa was evaluated after their incubation in antisperm antibodies-positive serum from an infertile male in the presence and absence of female sera or PFs. SETTING: Russian Scientific Center for Obstetrics, Gynaecology, and Perinatology. PATIENT(S): Serum and PF samples from fertile and infertile women; antisperm antibodies-positive serum from infertile men; high-quality fresh semen from healthy donors. INTERVENTION(S): Serum samples were obtained from fertile and infertile women and from infertile men. Peritoneal fluids were collected during routine laparoscopy. MAIN OUTCOME MEASURE(S): The proportion of spermatozoa positive for IgG antibodies and the quantity of antisperm antibodies on the sperm surface measured by flow cytometry (FCM). RESULT(S): The addition of sera from fertile or infertile women with endometriosis or pelvic adhesion disease to an IgG antisperm antibodies-positive male serum resulted in significant inhibition of the antisperm antibodies binding to the sperm surface. CONCLUSION(S): Sera of fertile as well as infertile woman contain factors that block IgG antisperm antibodies binding to the surface of live spermatozoa.

[Dual-channel microfluorometer-photometer based on standard block assemblies and units]. / Dvukhvolnovyi mikrofluorimetr-fotometr na baze standartnykh blokov i uzlov.

The principles of construction and methods of practical realizing of double-wave microfluorometers-photometers for investigation of molecular processes in cells and cell populations are considered.

[Obligate anaerobic microbes in obstetric and gynecologic diseases]. / Obligatno-anaérobnye mikroorganizmy pri akushersko-ginekologicheskoi patologii.

The paper reviews recent-years' papers and the data of their own investigations on a role of obligate anaerobic microbes in obstetric and gynecological abnormality. The fact that secondary pelvic inflammatory processes caused chiefly by non spore-forming anaerobes is ascertained. There is evidence that obligate anaerobic bacteria are involved in the abnormality directly unassociated with the development of an inflammatory process: preterm labor, premature discharge of amniotic fluid, intranatal fetal hypoxia, respiratory distress syndrome and hyaline membrane disease of the premature newborn. Among vaginal infections the key role is played by bacterial vaginosis which is, from the pathophysiological point of view, now a severe derangement of the vaginal environment system with greatly prevalent obligate anaerobic bacteria and without lactoflora. Complications associated with this abnormality are noted.

[Immunology of reproduction]. / Immunologiia reproduktsii.

The paper presents the results of studies of the role of immune factors in the pathogenesis of infertility, impaired gestation, and perinatal abnormalities, which have been performed at the Research Center of Obstetrics, Gynecology, and Perinatology, Russian Academy of Medical Sciences, in the past decade. It gives an evaluation of the contribution of antispermatic antibodies to infertility of unclear genesis, the systemic and local factors of immunity in females with endometriosis, the immune and interferon status in those with sexually transmitted infections, the role of immune factors and intrauterine infection in gestational abnormalities, the involvement of autoimmune mechanisms in reproductive disturbance. The trends of further studies are outlined.

[Pharmacokinetics of mifepristone and kinetics of chorionic gonadotropin beta-subunit (beta-HCG) and progesterone in plasma of pregnant women during pharmacological interruption of early pregnancy]. / Farmakinetika mifepristona i kinetika beta-sub''edinitsy khorionicheskogo gonadotropina (beta-KhG) i progesterona v plazme krovi beremennykh zhenshchin pri medikamentoznom preryvanii rannei beremennosti.

Reliable correlations between the parameters of mifepriston pharmacokinetics describing the rate of drug elimination from the blood plasma and the levels of beta-human chorionic gonadotropin (beta-HCG) and progesterone reflecting the state of gestation in females have been established fore the first time. According to these relationships, the half elimination time, the mean retention time, and the plasma clearance of mifepriston can be considered as predictors of the clinical efficacy of this drug for the early pregnancy interruption.

[Changes in the central and peripheral hemodynamics during combined electroanalgesia (CEA) during gynecological operations]. / Izmenenie na tsentralnata i perifernata khemodinamika v usloviiata na kombinirana elektroanalgeziia (KEA) pri ginekologichni operatsii.

Central and peripheral hemodynamics was examined in 180 women with gynecological diseases, divided into the following groups: 130 women of the basic group, operated under the conditions of combined electroanalgesia, and 50 women of the other group, operated under the conditions of combined endotracheal anesthesia, using the preparations droperidol and phentanyl. Both central and peripheral hemodynamics in both groups were characterized by stability at all stages of the operation. Both types of anesthesia protect reliably the organism from operative trauma. The concentration of cortisol in both groups presented values higher than the initial values before premedication, which proved that adequate reaction of the organism was preserved during operation under the conditions of anesthesia.

[Changes in the content of beta-endorphin in maternal and fetal blood during transcutaneous electric neurostimulation in premature labor]. / Izmenenie soderzhaniia beta-éndorfina v krovi materi i ploda v usloviiakh primeneniia chreskozhnoi élektroneirostimuliatsii pri prezhdevremennykh rodakh.

The effect of various parameters of transcutaneous electrical neurostimulation (TENS) on changes in B-endorphin (BE) blood plasma level has been studied in the mother and fetus during premature labour. A dependence of changes in BE plasma level on the frequency regimen of the impulse current has been established. The data, on the one hand, demonstrate the regulating effect of high- and low- frequency TENS on BE blood level and, on the other hand, indicate the involvement of endogenous opioid fetus system, which enables it to endure labour-induced stress.

[The choice of anesthesia during abdominal delivery in patients with severe forms of late pregnancy toxemias]. / Vybor anestezii pri abdominal'nom rodorazreshenii u bol'nykh s tiazhelymi formami pozdnego toksikoza beremennykh.

Sixty eight anesthesia procedures during abdominal delivery in patients with late toxemia of pregnancy have been analysed. In 32 cases the diagnosis was preeclampsia, in 8 cases--eclampsia, in 28 cases III degree nephropathy. Depending on the variant and method of anesthesia the subjects were divided into 3 clinical groups. Group I comprised 31 women to whom cesarean section was performed under general endotracheal anesthesia. In group II (24 pregnant women) analgesia was achieved by prolonged epidural anesthesia (PEA). In group III (13 patients) a combination of PEA and superficial endotracheal anesthesia was used. Analysis of the anesthesia techniques in patients with severe late toxemia of pregnancy has established that in endotracheal anesthesia it is sometimes impossible to block completely pathological and operation-induced nociceptive pulsation. PEA has a good analgetic effect but ensures no neuroautonomous protection, and upon discontinuation of action of the local anesthetic there is a danger of the onset of the convulsion syndrome and signs of preeclampsia or eclampsia. Taking into account the advantages and disadvantages of endotracheal anesthesia and PEA, a technique based on the combination of both variants has been selected, which ensures optimal anesthesiological protection in abdominal delivery.

[The validation of the use of Moradol for anesthesia in spontaneous labor]. / Obosnovanie primeneniia moradola dlia obezbolivaniia samoproizvol'nykh rodov.

Pharmacodynamic and pharmacokinetic peculiarities of moradol have been studied during natural delivery. It has been shown that moradol injected both intramuscularly and intravenously in the first period of labour did not inhibit the circulation in the women in labour, had no impact on the course of labour and had no negative effect on the newborn. The use of moradol is recommended for analgesia of natural delivery. A correlation has been established between blood drug concentration and its pharmacodynamic indexes in women.