[PATHOGENETIC TREATMENT OF CHRONIC NONBACTERIAL PROSTATITIS COMPLICATED BY SPERM DISORDERS].

This study examines the efficacy and safety of the natural complex of multi-component biologically active dietary supplement Prostatinol in the pathogenetic treatment of 45 patients with chronic nonbacterial Prostatitis complicated by sperm disorders. Within 4 weeks 25 patients of the treatment group and 20 patients of the control group received Prostatinol or traditional anti-inflammatory therapy correspondingly. The results were evaluated at weeks 4 and 12 after treatment cessation. Prostatinol was found to significantly increase the treatment effectiveness. More pronounced positive clinical effect was noted in 92% of treatment group patients receiving Prostatinol (disappearance of perineal pain, reduction of the IPSS score to an average of 2.1 points, absence of residual urine, normal Prostate echotexture, improvement of Prostate circulation, increase of sperm concentration and motility, higher pregnancy incidence among the wives of the treated patients). In the control group similar treatment effect was achieved in twice less number of patients. These results confirm that the components of the Prostatinol complex are effective, safe, have no side effects and can be used in the treatment of chronic Prostatitis, as well as for prevention of Prostatic diseases and improvement of sexual function.

[Treatment of chronic prostatitis caused by chlamydial and ureaplasmic infection and complicated with male infertility].

Etiologically, chronic prostatitis can result from urogenital latent infections caused by chlamydia, ureaplasma and others. First of all, such patients should be examined for urethritis. We examined 306 patients aged 23-45 years with chronic prostatitis caused by chlamydial and ureaplasmic infection. The samples were taken from the urethra, urine, prostatic secretion, ejaculate and were examined using direct immunofluorescence, polymerase chain reaction, culturing. We found spermatogenetic disorders in 50% patients, 35 (11.4%) patients had a deferent duct obstruction. The patients had also immunointerferon deficiency and alterations in prostatic echostructure. In chronic prostatitis caused by chlamydial-ureaplasmic infection the treatment must combine antibacterial drugs (vilprophen, unidox, solutab) with interferons (lavomax, genferon). Male infertility treatment should be started only after elimination of the bacterial infection.

[Diagnosis, prevention and treatment of renal lesion in extracorporeal shock wave lithotripsy].

The diagnosis and treatment of 120 patients with urolithiasis were made. The following examinations were made: the study of immune status and lipid peroxidation, detection of selective proteinuria, leukocyte migration inhibition reaction with autoantigens obtained from the tissues of the renopelvic segment providing additional information about renal parenchyma and immune system. The patients were divided into two groups: 70 patients of the study group received pre-, intra- and postoperative preventive pharmacotherapy, while 50 patients of the control group received standard therapy. It is shown that preventive measures in the patients of the study group aimed at raising resistance of the kidney to the shock wave and prevention of infectious-inflammatory process evidence for necessity of the above measures not only before extracorporeal shock wave lithotripsy, but also in intra- and postoperative periods.

[Clinicoimmunological disorders in patients with chronic prostatitis caused by latent urogenital infection].

The study enrolled 506 males 20 to 50 years of age (mead age 30.8 +/- 0.5 years) with chronic prostatitis (CP). Group 1 consisted of 332 (65 +/- 4.1) patients with CP caused by lateral urogenital infection (LUGI) due to chlamydias, ureaplasmas, mycoplasmas, gardnerellas, herpes virus type 2. Group 2 comprised 174 patients free of LUGI. T-cell and humoral immunity parameters were assessed by T-lymphocytes CD3, T-helpers CD4, T-suppressors CD8, CD4/CD8, natural killer cells CD16 using indirect immunofluorescence. Phagocytic activity of T-lymphocytes was estimated with latex as the antigen. An etiological factor was ureaplasmas, chlamydias and others in 170 (51.2 +/- 5.4%) and 155 (46.7 +/- 5.4%) patients, respectively. Mixed infection was diagnosed in 94 (28.3 +/- 4.8%) patients. Secondary immune and interferon deficiencies were detected in 155 (30.6%) patients of both groups. The patients received etiological (antimicrobial) and pathogenetic (immunological) therapy. The highest effect was obtained in prostatitis caused by mono-LUGI. Pain and pollakiuria attenuated, the copulative function improved. The conclusion is made that CP, especially secondary to LUGI, should be treated by combination of etiotropic with immunotropic methods.

Immunochemical study of the cyclic nucleotide system of retinal photoreceptor membranes: antibodies raised to phosphodiesterase, its protein inhibitor and GTP-binding proteins.

Monospecific precipitating antibodies raised to phosphodiesterase, its protein inhibitor and GTP-binding proteins of bovine retina photoreceptor membranes were obtained. The characterization of the antibodies was carried out by immunochemical methods and according to their functional properties as determined by their effect on enzyme activities. The antibodies were used to study the distribution of immunolike proteins in different animal retinas and to purify the inhibitor protein by the method of immunoaffinity chromatography.

[Influence of effectors of hormone-sensitive adenylate cyclase on the activation system of photostimulated cyclic nucleotide phosphodiesterase from outer rod segments]. / Vliianie éffektorov gormonchuvstvitel'noi adenilattsiklazy na sistemu aktivatsii fotostimuliruemoi fosfodiesterazy tsiklicheskikh nukleotidov v naruzhnykh segmentakh palochek setchatki.

The effect of preincubation of preparations of the outer segments of optic rods with the nonhydrolyzed analog GTP-guanilyl-5'-imidodiphosphate (Gpp(NH)p) and NaF, the combined effect of these agents as well as the action of (NH4)2SO4 (10-800 mM), MgSO4 (2-50 mM) and induction of peroxide oxidation of lipids are studied as applied to the catalytic activity of phosphodiesterase of cyclic nucleotides. Gpp(NH)p and NaF are shown to be tightly bound to GTP-binding proteins (G-proteins) of outer segments of optic rods, additional activation of phosphodiesterase in the presence of Gpp(NH)p being observed after preincubation with NaF and subsequent washing of the membrane. A problem on different binding sites of the ion F and Gpp(NH)p on G-proteins is discussed. It is found that (NH4)2SO4 does not affect the basal activity of phosphodiesterase but inhibits the activating effect of Gpp(NH)p and NaF on the enzyme. Induction of peroxide oxidation of lipids prevented by the addition of ionol (antioxidant) in a dose of 5.10(-4) M has the same effect. Changes in the concentration of Mg2+ in the medium influence insignificantly the basal activity of phosphodiesterase but are necessary for manifestation of the activating effect of Gpp(NH)p and NaF.

[Combined therapy of interstitial cystitis using the "Aeltis-Synchro-02-Iarilo" device]. / Kompleksnaia terapiia interstitsial'nogo tsistita s primeneniem apparata "Aéltis-Sinkhro-02-Iarilo".

Multiple modality therapy of interstitial cystitis (IC)--the disease characterized by nicturia, pelvic pains, imperative pollakiuria--is considered. As IC nature is not well known, its treatment remains empiric. Among the underlying causes, most probable are autoimmune, allergic, infectious, neurological, vascular. Therefore, the treatment should be multi-modality. Most usable now is combined chemotherapy. Perspective is also IC treatment with medicines in combination with physiotherapy (electromagnetolaser AELTIS-SYNCHRO-02-YARILO"). Endovesical electrophoresis can be also applied.

[Experience in wilaprafen treatment of chlamydial prostatitis, complicated by infertility]. / Opyt lecheniia vil'prafenom khlamidii prostitia, oslozhnennogo besplodiem.

The antichlamydial action of wilprafen was studied in patients suffering from urogenital chlamydial prostatitis complicated by infertility. An individual approach to etiotropic and pathogenetic therapy with wilprafen alone and in combination with vobenzim introduced by the authors in men with chlamydial prostatitis complicated by infertility produced a high curative effect.

[A luminescent cytological method of the determination of sex gonad hormonal activity in males]. / Liuminestsentno-tsitologicheskii metod opredeleniia gormonal'noi aktivnosti polovykh gonad muzhchin.

A method for assessing gonadal hormonal activity in men is suggested. It consists in fluorescent and cytologic examinations of navicular fossa epithelium making use of a fluorescent marker (acridine orange) and is based on specific sensitivity of navicular fossa epithelium to male sex hormones, because navicular fossa is formed in the course of embryogenesis from the urogenital sinus under the effect of androgen induction. Navicular fossa epithelium reacts to changed androgen/estrogen ratio by restructuring which is characterized by cellular apparatus regression or depression. Parallel with the cytologic reaction, blood androgen levels were measured in patients and normal subjects. The authors have developed a classification singling out four basic and four intermediate epithelial reactions. The suggested method was used in examinations of 327 patients with various andrologic abnormalities and of 96 healthy men. Examinations have demonstrated a high diagnostic value of this method in assessment of the hormonal balance (androgens and estrogens) in men and the possibility of using it as a screening test in andrologic abnormalities.

[Immunochemical similarity of GTP-binding proteins of various systems]. / Ob immunokhimicheskom podobii GTP-sviazyvaiushchikh belkov razlichnykh sistem.

It was found that antibodies specifically raised against GTP-binding proteins of bovine retina photoreceptor membranes block the inhibiting effect of estradiol on phosphodiesterase from human and rat uterus cytosol and prevent the combined effect of catecholamines and guanylyl-5'-imidodiphosphate on rat skeletal muscle adenylate cyclase. Using double radial immunodiffusion, it was demonstrated that the antibodies form a precipitating complex with purified tubulin from bovine brain as well as with retinal preparations obtained from the visual organs of ox, pig, rat, frog, some fish species and one reptile species. No appearance of a precipitation band was observed, when retinal preparations of invertebrates (squid, octopus) were used as antigens. The antibodies interacted with the alpha- and beta-subunits of GTP-binding proteins of bovine retinal photoreceptor membranes.

[GTP-binding proteins of the retinal photoreceptor membranes: purification, antibodies]. / GTP-sviazyvaiushchie belkie fotoretseptornykh membran setchatki: ochistka, antitela.

A scheme of immunization of rabbits with partially purified GTP-binding proteins isolated from ox retinal photoreceptor membranes has been developed. Using double radial immunodiffusion, it was shown that rabbit antiserum interacts with the GTP-binding proteins of the retinal phosphoreceptor membranes of ox, pig and frog. The antibodies interaction with the GTP-binding proteins of ox retinal rod outer segments was followed by immunoelectrophoresis as well as by elimination of the activating effect of the non-hydrolyzable derivative of GTP, guanyl-5'-yl-imidodiphosphate on cyclic nucleotide phosphodiesterase in illuminated photoreceptor membranes and in their extracts. A similar effect was exerted by immunoglobulins from immunized animals on the enzyme activation by NaF. Purified immunoglobulins type G did not practically interact with the GTP-binding proteins of the photoreceptor membranes.

[The role of testosterone undecanoate in correcting disorders of the copulative function]. / Rol' testosterona andekanoata v korrektsii narushenii kopuliativnoi funktsii.

Testosterone andecanoate (andriol) was used for treatment of copulative dysfunction in 18 young and middle-aged males in a dose 160 mg/day (a 10-12-day treatment course) or 40-80 mg/day (up to 6 week maintenance course). Clinical responses concerning such sexual symptoms as libido, erection, ejaculation and orgasm were achieved in most of the patients. Pretreatment blood levels of testosterone were not decreased. The treatment aroused these levels which persisted higher that pretreatment ones for 3 months. Estradiol was slightly higher after the treatment. Andriol is recommended for treatment of copulative dysfunction in young and middle-aged males.

[The role of sexually transmitted diseases in the childless marriage]. / Rol' zabolevanii, peredaiushchikhsia polovym putem, v besplodnom brake.

The effect of urogenital infection on reproductive function was studied in 326 infertile males. They were found to carry Chlamydia, Ureaplasma, Mycoplasma, Herpes, Gardnerella and mixed Chlamydia-Ureaplasma infections in 132, 84, 28, 16, 12 and 56 patients, respectively. Oligozoospermia of the first, second and third degree was diagnosed in 164, 128 and 34 males, respectively. Intermittent-course therapy included macrolid, chephalosporin and fluoroquinolone drugs, sometimes rifampicin, immunocorrection. Husbands and wives received treatment simultaneously. Secretory infertility was managed later. Oligozoospermia declined in two-thirds of the patients. 119 wives got pregnant.

[Sexual function after the surgical treatment of acute epididymitis]. / Polovaia funktsiia posle operativnogo lecheniia ostrogo épididimita.

Operative management of acute epididymitis performed in 150 patients aged 18-67 produced better therapeutic results compared to 150 patients treated conservatively (9.1 patient day versus 13.3 days). Follow-up for 2-4 years showed marked intergroup differences as regards anatomic changes in the epididymis revealed by palpation and ultrasound scanning. Echographic pattern was altered in 25 operated on and 92 patients treated conservatively. Copulative function was diminished in few cases in those operated on and much more frequently after conservative treatment, libido and erection in particular. Reproductive function was impaired more profoundly after conservative treatment as well. These patients demonstrated lower levels of testosterone and estradiol but higher content of LH and FSH. The latter hormones did not vary with age among the groups. Better effect of scrotal drainage in acute nonspecific epididymitides is attributed to the influence of inflammation-affected epididymis on the contralateral testicle more intensive under conditions of closed (nondrained) inflammation.

Estradiol receptor and cyclic nucleotide phosphodiesterase: functional relationship, possible role of guanine nucleotide binding proteins.

The inhibitory effect of estradiol (10(-9)M - 2 X 10(-5)M) on the cyclic nucleotide phosphodiesterase (EC 3.1.4.17) activity of cytosol from rat uterine tissue and human myometrium and endometrium was established. The hormone action was shown to disappear due to preparative separation of the receptor and the enzyme; the effect reappeared after protein mixing. In the presence of GTP, Gpp (NH)p, NaF and cholera toxin the estradiol action on the phosphodiesterase activity was significantly decreased or failed to be revealed. The antibodies raised against G-proteins of retina photoreceptor membranes abolished the hormone action on phosphodiesterase. A conclusion is drawn that in uterine tissue there exists a functional connection between estradiol receptor and phosphodiesterase. The necessary participation of G-proteins in signal transmission is postulated.

[Electrolaser therapy on the Iarilo device in patients with chronic chlamydial prostatitis]. / Elektrolazernaia terapiia na apparate "Iarilo" u bol'nykh khronicheskim khlamidiinym prostatitom.

Multiple-modality treatment (antibiotics, immunocorrectors, vascular medication, physiotherapy) for chronic chlamydial prostatitis (CCP) was conducted in 141 patients. They were assigned to two groups which differed only by physical methods applied. Group 1 patients (n = 84) were exposed to electrolaser radiation (Yarilo unit), group 2 patients (n = 57) were treated by conventional physiotherapeutic methods. The advantages were reported in the group treated simultaneously with He-Ne laser introduced into the urethra, infrared laser, electrostimulation (Yarilo unit). Perineal pain and dysuria ceased in 58.9 and 9.8%, 62.1 and 13.2% of patients from group 1 and 2, respectively. Erection recovered in 90% of group 1 patients. In group 2 this percentage was 50%.

[Extracorporeal lithotripsy in patients with the renal form of primary hyperparathyroidism]. / Distantsionnaia litotripsiia u bol'nykh s pochechnoi formoi pervichnogo giperparatireoidizma.

The role of PH in initiation of lithogenesis recurrences after extracorporeal lithotripsy (ECLT) was studied in 206 patients. Renal PH was diagnosed in 35 from 56 patients of group 1 with recurrent lithogenesis after ECLT. All the 35 patients underwent parathyroidectomy and repeated ECLT. The recurrence was seen only in 1 patient (2.9%). 150 patients of group 2 had complicated urolithiasis, 86 of them had renal PH. Prior to ECLT the above patients were subjected to prophylactic parathyroidectomy. Uroliths recurred in 2 patients (2.2%). It is thought valid before ECLT to examine urolithiasis patients for renal PH. In its presence the authors recommend to perform parathyroidectomy.