[Effectiveness of Vitaprost Plus in the treatment of patients with chronic bacterial prostatitis].

The need for use of antimicrobial drugs in the treatment of patients with chronic bacterial prostatitis is indisputable. Given the variety of pathogenic mechanisms of chronic prostatitis, drug Vitaprost Plus in the form of rectal suppositories is of particular interest; it combines antibacterial activity with a positive effect on the various links in the pathogenesis of this disease. The evaluation of the efficacy and safety of drugs Vitaprost Plus and Lomflox was performed. Both groups showed a significant improvement in the NIH-CPSI score in summary and on individual domains; differences between groups were not statistically significant. The number of leukocytes in the prostatic exprimate decreased more markedly in the study group. Microbiological efficacy in the study group was 73.3%, in the control group--70%. Thus, the use of the drug Vitaprost Plus increased clinical and microbiological efficacy of treatment, which correlates with the data of previous studies.

[Pneumocystic pneumonia].

The article is devoted to short description of epidemiology, clinical and radiologic demonstration of pneumocystic pneumonia. The features of pathologicoanatomic changes at pneumocystic pneumonia are described. Own observation about combination of classic and scarce histological changes at this disease is in the article.

[Morphologic and functional heterogeneous changes of the urinary bladder different parts at rats with infravesical obstruction of the urinary tracts].

Infravesical obstruction of the lower urinary tracts of 30 rats was carried out by the measured constriction of the urethral prevesical parts. Morphologic and functional changes of the urinary bladder different parts were studied in 1 week and in 3 months. Compensatory hypertrophy of the detrusor was accompanied increasing of hypertrophied, atrophic and native forms of leiomyocytes, as so their transformation into myofibroblasts with connective tissue formation between the muscle fibers mainly in the neck of urinary bladder Contractility of the detrusor decreased with their tonus increasing mainly in the neck of urinary bladder too. Weakening effect of adrenalin in 3 month after obstruction significantly decreased, while in the body and neck of urinary bladder it virtually disappeared. Blockade of alpha-adrenoreceptors after noradrenalin stimulation resulted in enchancement of the hypertrophic detrusor contraction when tonus of the urinary neck decreased. On the contrary, in the intact urinary bladder the similarly influence resulted in weakening of contraction.

[Early diagnosis of prostate cancer using histoscanning device].

For the purpose of improving diagnosis of prostate cancer (PC), the authors used an innovative HistoScanning device. According to the standard procedure accepted at the clinic, 326 patients admitted with suspected prostate cancer were evaluated. Patients with elevated prostate-specific antigen (PSA) were divided into three groups depending on the degree of its increase, which ranged from 1.09 to 209 ng/ml; Group 4 (conventional control) consisted of patients with BPH, and Group 5 (control) consisted of healthy men aged 21 to 28 years. At the next step, histoscanning was performed with construction of maps of the prostate, which was used when performing a biopsy. The results of histoscanning were compared with data of morphological examination of biopsy material, and with the data of visual and morphological studies of surgical specimens in patients undergoing radical prostatectomy. High diagnostic value of histoscanning was demonstrated, as even in patients of Group 1 sensitivity was 89%, specificity--96%, in patients of Group 2 and 3--96 and 94%, 99 and 97%, respectively. False positive results occurred in 11% of cases, false negative--only in 0.6%.

[Building of defects of the bladder wall by membrane, created on the basis of type I collagen (an experimental study)].

Experimental study was performed on 24 Chinchilla rabbits, which underwent resection of the bladder with building of defect by membrane "Collost", created on the basis of type I collagen. The functional state of the bladder in situ was assessed by infusion cystomanometry during repeated surgery at 7, 14 day and at 1, 3, 6 months, and at 1 and 1.5 years. It is found that developing detrusor pressure during bladder contractions was decreased by 10 times in the first week of the study; it was in line with the subcompensation after 3 months, and was restored at 6 month. At 1 and 1.5 years, increase of cumulative function of bladder while saving detrusor pressure was observed. Dilating cystoplastics using biopolymer "Collost" provides good long-term functional results.

[Regeneration of testicular tissue and restoration of rat fertility in xenotransplantation of enriched fetal cell cultures in bilateral abdominal cryptorchism].

The study of cell cultures enriched with stem and progenitor cells in the treatment of experimental hypergonadotropic hypogonadism was made on 30 white non-inbred rats with experimental cryptorchism who have undergone xenotransplantation of human fetal enriched cell cultures. Spermatogenic epithelium on histological sections was studied on day 14 and 28 after xenotransplantation with calculation of the spermatogenesis index. The fertility index was estimated for each of the groups. Transplantation of enriched cell cultures enhances efficacy of restoration of adequate germinogenic and spermatogenic testicular function, accelerates recovery of spermatogenesis and fertility with high indices of spermatogenesis and fertility but effect of the above recovery after treatment with enriched cell cultures can be seen not earlier than 72 days after transplantation.

[The morphologic and functional state of the kidneys exposed to focused waves during remote nephro-lithotripsy].

Clinical and experimental research has shown that complications connected with negative influence of focused waves in distant lithotripsy in litotripters with an electrohydravlic system of focused waves generation depend on many factors, including the regime of wave generator work, an electrode interval, defocusing the wave as a result of an electrode interval center displacement, the amplitude of pressure and the length of a wave impulse in positive and negative phases. The wave impulse is distorted, which leads to kidney tissue damage.

[Endoscopic correction of neuromuscular ureteral dysplasia in children].

The authors present pathogenetic rationale for using endoscopic intervention in neuromuscular ureteral dysplasia in children. A positive effect of this treatment occurs primarily in patients with a small area of sclerosis focus in the ureter. Such patients have high percentage of leiomyocytes with a great regenerative potential. This explains a response to endoureterotomy.

[Morphological changes in prostatic tissue of patients with benign prostatic hyperplasia treated with permixon]. / Morfologicheskie izmeneniia v tkani predstatel'noi zhelezy bol'nykh s dobrokachestvennoi giperplaziei predstatel'noi zhelezy pri lechenii permiksonom.

A pilot trial has been performed to assess effects of permixon on prostatic tissue in patients with benign prostatic hyperplasia (BPH). A total of 49 BPH and control patients entered the trial. 36 patients of the study group were randomized into 3 subgroups of 12 patients each. Permixon was taken in a standard dose of 320 mg/day for 3, 6 and 12 months, respectively. Mean duration of BPH was 3.7 years (0-8 years). Mean value of PCA was 6.0 ng/ml. The control group of 13 patients were not given permixon. Multifocal prostatic biopsy was performed in all the patients before and after the treatment or follow-up. Stromal-parenchymatous correlation in the study group significantly increased (by 59%)--from 3.28 (0.25-9.61) to 5.22 (1.20-10.67) (p = 0.0002). For the control group this correlation was insignificant. Permixon-treated patients demonstrated inhibition of prostatic epithelium proliferative activity by 32% (p = 0.0001) and a rise in the stage of proliferative centers development from stage II-III to IV-V. Intensity of inflammation in prostatic tissue decreased by 53% in the study group and insignificantly in the control group. Thus, permixon treatment of BPH leads to a significant rise in stromal-parenchymatous correlation due to inhibition of proliferative activity of prostatic epithelium and attenuation of inflammation.

[Intraprostatic injection of 96% ethanol in experimental animal model]. / Intraprostaticheskoe in''etsirovanie 96% étanola v éksperimental'noi modeli na zhivotnykh.

Transurethral intraprostatic injection of ethanol (IIE) is a new low-invasive method in the treatment of benign prostatic hyperplasia (BPH). We made dog and rat experiments to prove safety and efficacy of IIE. The experiment was made on 10 rats and 10 dogs injected transurethrally (Prostaject device) with 96% ethyl alcohol in 10% volume of estimated volume of the prostate. The injection was followed by measurement of blood alcohol, the test for hemolysis. Transurethral ultrasound control of prostate size 1, 3 and 6 months after the injection and histological examinations 1, 3, 7, 14 days and 1, 3 and 6 months after the injection were made. It was found that blood alcohol after the above injection was not elevated. Necrosis was documented in all the cases but subsequently the necrotic site was replaced with sclerotic tissue. The necrosis involved only the prostatic capsule. The size of the prostate diminished by 29%. Thus, transurethral injection of ethyl alcohol (10% of prostate size) is safe and effective in achievement of prostatic gland ablation. Therefore, clinical trials of the method in patients with benign prostatic hyperplasia are justified.

[Plastic surgical repair of the urethra with vascular fasciocutaneous and combined flap (experimental study)]. / Plastika uretry vaskuliarizirovannym kozhno-fastsial'nym i kombinirovannym loskutom (éksperimental'noe issledovanie).

The experiments on 15 dogs with preformed urethral stricture or urinary urethral fistula have demonstrated that microsurgical transplantation of the vascular fasciocutaneous pedicle flap provides good functional long-term results. The best effect was achieved in cases of intraflap inclusion of previously transplanted mucosa of the urinary bladder. In all 7 experiments x-ray picture was similar to normal. Recurrent strictures or urethral fistulas were not registered. Urodynamic indices late after the experiment did not differ significantly from normal values.

[Change in indicators of metabolism and kidney function in intact rats after parenteral administration of sodium hypochlorite]. / Izmenenie pokazatelei metabolizma i funktii pochek u intaktnykh krys posle parenteral'nogo vvedeniia gipokhlorita natriia.

The changes of kidney metabolism, function and enzymuria activity of nephron epithelium cells after 4 days of parenteral administration of sodium hypochlorite 0.02% and 0.06% solutions were investigated in the experiments on 15 intact non-inbred rats of 200-280 g body weight. It was revealed that sodium hypochlorite induced metabolic damage to the kidney similar to ischemic one. The 0.02 and 0.06% solutions of sodium hypochlorite administered parenterally produced no negative effect on renal function. There was no significant rise of enzymuria activity in experimental groups compared to the controls. Moreover, enzymuria of four from six nephron epithelium cell enzymes decreased significantly to day 5 of the experiment. Metabolic damage and enzymuria activity changes were more pronounced in rats given parenteral 0.06% solution of sodium hypochlorite.

[Long-term surgical treatment outcome in ureteral neuromuscular dysplasia in children]. / Otdalennye rezul'taty operativnogo lecheniia neiromyshechnoi displazii mochetochnikov u detei.

178 patients with ureteral neuromuscular dysplasia (UND) treated surgically were followed up for maximum 8 years. The following operations were made: resection of the stenosed part with antireflux operation by Politano-Leatbetter, Hendren operation, Lopatkin-Kalichinsky operation. Functional results depended on the condition of leiomyocyte regenerative reserves, deficiency of secretory renal function and the surgical method. In ureteral achalasia (by N. A. Lopatkin's classification) it is recommended to perform resection of the stenosed part by Politano-Leatbetter antireflux technique, in megaureter and ureterohydronephrosis Lopatkin-Kalichinsky operation is preferable.

[Morphofunctional characteristics of erythrocytes in extracorporeal efferent detoxication]. / Morfofunktsional'naia kharakteristika éritrotsitov pri ékstrakorporal'noi éfferentnoi detoksikatsii.

The erythrocyte morphology (scanning electronic microscope, the superficial erythrocyte charge, the lipid peroxidation rate and the blood viscosity were investigated in 78 patients, treated by use of hemodyalisis, hemosorbtion, plasmosorbtion and hyperbaric oxygenation to correct the chronic renal insufficiency and the purulent intoxication. The described erythrocyte changes reflect the features of definite kind of the efferent treatment and the program of its use, the individuality of the patient initial state. The efferent methods of treatment cause significant and mostly differently directed changes in the peripheral red blood. Morphologic and functional parameters of the erythrocytes appear to be important diagnostic criteria of the efficiency of the extracorporal methods of detoxication.

[Use of a three-component scheme of immunosuppression on morphologic and immunohistochemical changes of transplants in the early postoperative period]. / Primenenie trekhkomponentnykh skhem immunosupressii na morfologicheskie i immunogistokhimicheskie izmeneniia transplantata v blizhaishem posleoperatsionnom periode.

Three-component (cyclosporin A, corticosteroids and azathioprine) immunosuppression has been widely introduced in the treatment of recipients of renal transplants because it allows a significant reduction of the components' doses in greater effectiveness. The analysis of the results of 83 puncture biopsies obtained in the immediate postoperative period after kidney transplantation has shown that administration of an imidazole derivative allows raising therapeutic concentration of cyclosporin up to 200-300 ng/ml, thus preventing rejection crises. However, increased blood concentration of cyclosporin does not increase its toxicity as a result of a significant fall in the overall level of the metabolites.

[Increase in structural-functional tolerance of kidney to ischemia upon parenteral administration of sodium hypochlorite in the pre-ischemic period]. / Povyshenie strukturo-funktsional'noi tolerantnosti pochek k ishemii pri parenteral'nom vvedenii gipokhlorita natriia v predyshemicheskom periode.

The opportunity of raising kidney structural and functional tolerance to ischemia with parenteral injections of 0.06% solution of sodium hypochlorite for 4 days in preischemia period was studied in experiment on 22 non-inbred rats of 200-280 g body weight. 90 minute ischemia was created by ligating the left and right kidney arteries, veins, ureters. Morphological and functional kidney data, enzymuria activity of nephron epithelium cells were registered, 80 and 33% of the rats survived 7 days after ischemia in the study and control groups, respectively. The control animals showed deterioration of the tubules function, high enzymuria. Thus, it is possible to raise kidney tolerance to ischemia by preischemic parenteral injection of sodium hypochlorite solution.

[Postoperative cystitis in children]. / Posleoperatsionnyi tsistit u detei.

Operative intervention on the urinary bladder in children entails postoperative reactive cystitis. Biopsies of urinary bladder mucosa were studied morphologically. Basing on these morphological findings and clinical evidence, three leading variants of the mucosa changes were distinguished: focal squamous cell metaplasia; excess of the lymphoid tissue and lymphangiectasia; hemangiectasia. These morphological changes aggravate the course of postoperative cystitis. UHF-therapy and magnetic-laser radiation beginning postoperative day 4 and 7, respectively, reduce inflammation developing in postoperative cystitis. This indicates effectiveness of the above combined therapy which can be also used for prevention of acute inflammation episodes in postoperative period.

[Morphofunctional characteristics of erythrocytes in chronic kidney failure and purulent intoxication]. / Morfofunktsional'naia kharakteristika éritrotsitov pri khronicheskoi pochechnoi nedostatochnosti i gnoinoi intoksikatsii.

The morphology of blood erythrocytes was examined under a scanning electron microscope and erythrocyte surface charge, lipid peroxidation on erythrocyte membranes, and blood viscosity were studied in 213 urological patients with chronic renal insufficiency (CRI) and purulent intoxication (PI) of different severity. CRI and PI were characterized by morphofunctional changes in erythrocytes, which depended on the type and severity of intoxication. Changes in erythrocyte morphology in CRI and PI were paralleled by a decrease in their negative surface charge and activation of lipid peroxidation. These parameters can serve as diagnostic tests for evaluation of the severity of intoxication.

[Pathogenetic bases for choosing treatment for vesicoureteral reflux in children]. / Patogeneticheskie osnovy vybora lecheniia puzyrno-mochetochnikovogo refliuksa u detei.

600 children treated surgically or conservatively for vesico-ureteral reflux (VUR) at the age 3 months to 15 years were followed up for maximum 28 years. The course of compensatory processes in the kidney with considering the cause of VUR development at different stages of life (childhood, adolescence, adult life) and the degree of renal function loss were specified. Morphologic studies of renal parenchyma help choosing treatment of VUR in children depending on the cause of its development: malformation of ostium ureteris and intramural ureter, inflammation in the urinary bladder.

[Gastrointestinal hemorrhage in urological diseases]. / Zheludochno-kishechnye krovotecheniia pri urologicheskikh zabolevaniiakh.

The authors analyse 28 cases of gastrointestinal hemorrhage (GIH) in urological diseases and after uronephrological operations, emphasize factors of uremic intoxication and relevant complications provoking DIC syndrome. Various factors leading to stress (acute blood loss, shock, sepsis) and development of immunodeficiency disturbed morphostructure of gastric and duodenal mucosa and provoked hemorrhage which was stopped most efficiently by fibrogastroduodenoscopy with coagulation of the bleeding vessel. If this operation failed, open surgery was performed. Conservative measures consisted in DIC syndrome management policy.