[Immune response to lower urinary tract infections].

Urinary tract infections are one of the most common and widespread infectious diseases. A certain role in etiopathogenesis may play genetic predisposition, as well as a decrease in antiadhesive properties and an increase in urothelium permeability due to incompetence of bladder glycosaminoglycan layer. The prevalence of infectious diseases increases significantly with age, as well as in patients with chronic diseases. The introduction of modern biotechnology has allowed clinicians to greatly expand therapeutic armamentarium, while having a number of advantages, including minimal frequency of complications and adverse events, the possibility for long-term use, accessibility, and etc. Priority research areas include the study of toll-like receptors, which are transmembrane proteins that provide pathogen recognition and activate the immune response. The role of these receptors in the development of the immune response to urinary tract infections was evaluated in our study, which allows to predict the course of the disease and to increase treatment efficiency.

[Results of urethral reconstruction in adults after multiple hypospadias repairs].

AIM: To improve treatment results in patients after multiple hypospadias repairs by optimizing the postoperative management. MATERIALS AND METHODS: Eighty-two patients (mean age 48.1+/-15.3 years) with urethral strictures secondary to failed hypospadias repairs underwent staged graft urethroplasty using oral mucosa (cheek, lip, tongue) as a grafting material. In 62 patients, at the end of surgery the bladder was drained with a standard Foley catheter. In twenty patients the bladder was drained with a modified silicone urethral catheter, which had an additional channel for delivering drugs and removing the urethral wound effluent, and a second additional channel for inflating a balloon fixed to the catheter tube at different parts of the catheter. RESULTS: The mean length of the stricture was 5.4+/-1.2 cm (from 1 to 16 cm). Twenty-eight patients had postoperative complications. Using the modified catheter resulted in statistically significantly (p<0.05) smaller percentage of complications (10% vs 41.9%) compared to standard Foley catheter. Urinalysis and sperm test on the follow up examination at 12 months showed that only 9 (10.9%) patients had signs of the inflammatory process. Seventy-five patients (91.5%) rated the appearance of the penis as "good"; only 5 (6.1%) and 2 (2.4%) patients considered the result as "satisfactory" and "unsatisfactory", respectively. Eighty patient (97.6%) regarded the treatment result as "good" for the quality of urination and only two (2.4%) considered it "satisfactory". When assessing the strength of urinary stream, 64 (78.1%), 13 (15.8%) and 5 (6.1%) patients rated it as "good", "satisfactory", and "unsatisfactory", respectively. CONCLUSION: The study findings shows that staged urethroplasty using the oral mucosa restores the urethral patency, reduces the severity of the inflammatory process, thus improving the quality of life of patients after failed hypospadias repair. The proposed modification of the catheter ensures the timely delivery of drugs to the surgical site, evacuation the wound effluent from the urethra and helps prevent strictures by periodically inflating the adjustable balloon-dilator.

[Effectiveness and safety of degarelix in treating hormone-sensitive prostate cancer: review of the recent literature].

Since their first clinical use in 1990 and up to the present time, the luteinizing hormone-releasing hormone (LHRH) analogues have formed the mainstay of androgen deprivation therapy of patients with hormone-sensitive prostate cancer. The transient testosterone surge inherent in this group of hormonal therapy medications might contribute to cardiovascular complications, limiting to some extent their use. Conversely, LHRH antagonists have a minimal adverse effect profile and their use in clinical practice is seen as more promising. The most extensively studied and widely available LHRH antagonist is degarelix. It should be noted that degarelix is currently only available as a depot formulation given as a monthly injection which may be viewed as a disadvantage.

[QUALITY OF LIFE IN PATIENTS UNDERGOING PROSTATE CRYOABLATION].

Not long ago, survival rates were the primary outcome measures of surgical management of prostate cancer. Currently, more attention is paid to the quality of life, because even minor changes in the quality of life can lead to serious alterations in the psycho-emotional status and significantly reduce patients' self-esteem. Most experts believe that the quality of life of patients treated for prostate cancer, is mostly affected by urinary incontinence, erectile dysfunction, urethral stricture, and bowel dysfunction. Thanks to advances in the treatment of prostate cancer, the incidence of complications was reduced to a minimum. To some extent, this was due to the use of novel minimally invasive treatment for prostate cancer, such as cryoablation, interstitial brachytherapy and HIFU-therapy. The quality of life in 65 patients undergoing cryoablation of the prostate was evaluated using EORTC QLQ-C30 questionnaire. Analyzing the findings of the survey enabled us to estimate the patients' quality of life, as well as to identify the various components of the postoperative health problems.

[Perineal saturation biopsy of the prostate].

The effectiveness of perineal biopsy for the detection of prostate cancer (PC) using an array for brachytherapy/cryotherapy was evaluated. It is shown that perineal saturation biopsy provides high detection rate of prostate cancer in patients with suspected cancer after negative transrectal biopsies, does not increase the detection of clinically insignificant cancer and incidence of complications, but requires a lot of time and cost.

[Benign mimics of prostatic adenocarcinoma].

Prostate cancer occupies 2nd place on the prevalence and 6th place on mortality among all cancers in men. That is not to deny the social importance of prostate cancer, but attention is drawn to significant advantage of newly detected cases above the cancer-specific mortality. "Gold standard" for diagnosis includes morphological study of tissue fragments after transrectal multifocal prostate biopsy. The importance of the differential diagnosis is particularly relevant when analyzing fragments of prostate tissue obtained from biopsies as a false positive result may cause unnecessary and excessive treatment. This article presents the most common benign processes that can simulate various grade adenocarcinoma. Awareness about the presence of such cancer mimics and careful examination of micropreparations in most cases allows to come to the correct conclusion.

[Treatment of prostate cancer using cryoablation: a prospective study].

Currently, the choice of tactics of treatment of the patient with prostate cancer (PCa) requires to take into account the degree of differentiation and stage of tumor, age of the patient and his somatic diseases, the risk of complications, as well as the patient's desire and physician's experience. Due to the progressive development of medical technology, interest in minimally invasive treatments for prostate cancer, such as cryoablation, interstitial brachytherapy and HIFU-therapy, has grown. Cryoablation of the prostate gland is a tissue ablation by local effects of very low temperatures and is minimally invasive, highly effective treatment for prostate cancer that can be used as the primary treatment, and in the case of tumor recurrence after radiotherapy. Focal cryoablation of the prostate allows to selectively destroy the known tumor with preservation of organ function and without reducing the quality of life of the patient. Focal therapy for prostate cancer is an alternative to radical treatment and active surveillance, occupying an intermediate position between them. Due to the lack of long-term results, focal cryoablation is an experimental type of treatment. First cryoablation of the prostate using modern equipment was carried out in Russia in March 2010, at the Department of Urology MSMSU. Since that time, we performed this procedure in 122 patients with prostate cancer; cryoablation was primary treatment in 110 patients and was used as salvage treatment in 12 patients. In most cases, the operation was performed under epidural or spinal anesthesia. According to the protocol, all the patients underwent 2 cycles of freezing and thawing under transrectal ultrasound guidance. A significant improvement of equipment for cryosurgery, the use of cryoneedles with smaller diameter, and the use of temperature sensors and catheters to warm the urethral mucosa have allowed to minimize the number of complications in comparison with other methods of treatment of prostate cancer and achieve a high disease-free survival. Our prospective study was aimed to analyze our own results cryoablation of the prostate gland.

[A comparative analysis of chromatographic, kinetic and antigenic properties of casein kinase type 2 from bovine liver and the phytopathogenic mushroom Verticillium dahliae]. / Sravnitel'nyi analiz khromatograficheskikh, kinetichskikh i antigennykh svoistv kazeinovykh kinaz tipa 2 iz pecheni byka i fitopatogennogo griba Verticillium dahliae.

Homogeneous preparations of casein kinases 2 have been isolated from bovine liver and the phytopathogenic fungus Verticillium dahliae. The isolation procedure was similar in both cases and included consecutive chromatography on heparin-Sepharose, phosphocellulose PII and monoQ. The bovine liver enzyme consists of two subunits with molecular masses of 38 kDa and 27 kDa, while the fungus kinase has three subunits with Mr of 53 kDa, 41 kDa and 38 kDa. Self-phosphorylation of casein kinase 2 in vitro resulted in phosphate incorporation into the smaller subunit of the mammalian enzyme and into all the three subunits of the fungal enzyme. The Km value of casein kinase 2 from bovine liver for ATP is 3.1 microM; that for GTP is 22.0 microM. The corresponding parameters of the fungal kinase are 14.3 and 18.2 microM, respectively. Specific antibodies to each kinase have been raised. The lack of antigenic cross-reactions between the two enzymes has been demonstrated by ELISA.