СРАВНИТЕЛЬНЫЙ АНАЛИЗ БАКТЕРИАЛЬНОЙ ПОПУЛЯЦИИ ПРОСТАТЫ ПРИ РАКЕ И ДОБРОКАЧЕСТВЕННОЙ ГИПЕРПЛАЗИИ ПРОСТАТЫ

A bacteriological study of prostate biopsy specimens was conducted in patients with prostate benign hyperplasia (PBH) and in those with prostate cancer (PC). It revealed a wide range of aerobic (Corynebacterium sp., Enterococcus sp., E. coli, S. haemolyticus, S. hominis) and nonclostridial anaerobic (Bacteroides sp., Bifidobacterium sp., Eubacterium sp., Propionibacterium sp., Рeptococcus niger, Peptostreptococcus sp., Prevotella sp., Veilonella sp., Fusobacterium sp., Capnocytophaga ochracea, Streptococcus parvulus) bacteria. Differences were seen in the detection rate of these microorganisms and in the level of tissue infectivity in PBH and PC. The average seeding of the prostate biopsy specimens and the detection rate of different types of bacteria in PBH were greater than those in PC; moreover, some bacteria were undetectable in PC at all.Проведено бактериологическое исследование биоптатов предстательной железы (ПЖ) у пациентов, имеющих доброкачественную гиперплазию предстательной железы (ДГПЖ) и рак предстательной железы (РПЖ). Выявлен широкий спектр аэробных (Corynebacteriumsp., Enterococcussp., E. coli, S. haemolyticus, S. hominis) и неклостридиально-анаэробных (Bacteroidessp., Bifidobacteriumsp., Eubacteriumsp., Propionibacteriumsp., Рeptococcusniger, Peptostreptococcussp., Prevotellasp., Veilonellasp., Fusobacteriumsp., Capnocytophagaochracea, Streptococcusparvulus) бактерий. Определены различия в частоте обнаружения данных микроорганизмов и уровне инфицированности ткани при ДГПЖ и РПЖ.Средний уровень обсемененности биоптатов простаты и частота выделения различных видов бактерий при ДГПЖ превышают таковые при РПЖ, причем некоторые бактерии при РПЖ не обнаруживаются вовсе

EFFECTIVENESS AND SAFETY OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY FOR UNCOMPLICATED PELVIC CONCREMENTS

Introduction. Extracorporeal shockwave lithotripsy (ESWL) allowed to improve the treatment results for patients suffering from the kidney stone disease (KSD), decrease the number of complications, optimize the nearest and distant therapy results; however, its success depends on the initial size and shape of the stone. Purpose of the study. Тo examine the clinical effectiveness and safety of electromagnetic ESWL used on simple renal calculi taking their sizes into account. Materials and methods. The survey included 110 patients with simple renal calculi who passed electromagnetic ESWL procedures. The first group consisted of 75 patients with calculi ≤ 15 mm in diameter, the second group included 35 patients with stones > 15 mm. Results. Complete disintegration of stones ≤ 15 mm was accomplished in 74,7% of cases in 1-2 lithotripsy sessions, and after 3 months residual fragments were found in 4% of cases only. Elimination of stones > 15 mm from the renal collecting system takes considerably longer, all patients require more than 1 lithotripsy session. In 3 months following the ESWL residual stones were found in 17,2% of analysed cases. Stone sizes had no bearing on the pain syndrome frequency and severity as well as activation of urinary infection. Macrohematuria, renal haematomas, and an increase of blood creatinine level compared with the original value were more frequent in patients with stones > 15 mm. Conclusions. Electromagnetic ESWL is an efficient and safe method for monotherapy of patients with uncomplicated pelvic concrements. Clinical ESWL effectiveness for stones ≤15 mm by the 3rd month of monitoring reaches 96,0%, for stones > 15 mm it is 82,8% (р<0,05). The level and severity of complications is higher in case of pelvic stones >15 mm compared with the stones < 15 mm in diameter (р<0,05)

COMPARATIVE ANALYSIS OF THE BACTERIAL POPULATION OF THE PROSTATE IN ITS CANCER AND BENIGN HYPERPLASIA

A bacteriological study of prostate biopsy specimens was conducted in patients with prostate benign hyperplasia (PBH) and in those with prostate cancer (PC). It revealed a wide range of aerobic (Corynebacterium sp., Enterococcus sp., E. coli, S. haemolyticus, S. hominis) and nonclostridial anaerobic (Bacteroides sp., Bifidobacterium sp., Eubacterium sp., Propionibacterium sp., Рeptococcus niger, Peptostreptococcus sp., Prevotella sp., Veilonella sp., Fusobacterium sp., Capnocytophaga ochracea, Streptococcus parvulus) bacteria. Differences were seen in the detection rate of these microorganisms and in the level of tissue infectivity in PBH and PC. The average seeding of the prostate biopsy specimens and the detection rate of different types of bacteria in PBH were greater than those in PC; moreover, some bacteria were undetectable in PC at all

MICROBIOTA URINE AND ANTIBIOTIC PROPHYLAXIS FOR LITHOTRIPSY SIMPLE JUNCTION STONES

Extracorporeal shock wave lithotripsy (ESWL) may be associated with infectious and inflammatory complications. The dynamics of the microbial spectrum of urine and the need for antibiotic prophylaxis are still poorly understood. The study included 40 patients with simple pelvic stones, which one session was held ESWL. Bacteriological examination were taken midstream urine to ESWL, when the first urination after ESWL, 1, 3, 7 days. Patients were divided into 2 groups. Group I consisted of patients (60%) with antibiotic prophylaxis. Patients of group II (40%) of antibiotic prophylaxis was not performed. The pattern of isolated microorganisms were as follows: NAB - 92.5%, Gram-positive microorganisms - 70.0%, urease-producing microorganisms - 60,0%, E.coli - 12,5%. Dynamic study of the microbial spectrum of urine Group found that the prophylactic use of antibiotics after ESWL simple junction stones accompanied by increased frequency of occurrence and levels of contamination of urine urease-producing bacteria, Candida, Gram-positive microorganisms and increases the risk of infectious and inflammatory complications in connection with the question of the need for antibiotic prophylaxis to be decided individually

Relapses of urethral strictures associated with a pelvic ring fracture and osteosynthesis: the features of treatment and prevention

Introduction. Pelvic ring fracture with complex bone fragments displacement is associated with the urethral distraction injury in about 10% of cases. Emergency care for these patients includes the provision of trauma management and urinary diversion followed by delayed urethroplasty.Purpose of the study. To determine the effect of extramedullary osteosynthesis in a pelvic ring fracture on the outcome of treatment in patients with post-traumatic urethral strictures.Materials and methods. The study included 17 patients with post-traumatic urethral strictures associated with pelvic ring fractures (Types B, C). The average age of the patients was 35.8 ± 10.2 (19 - 61) yrs. All patients underwent submerged osteosynthesis and cystostomy drainage as an emergency. Localization of strictures: 10 (58.8%) - membranous, 7 (41.2%) - bulbo-membranous. Length of strictures: 1.47 ± 0.5 (0.5 - 2.5) cm. Post-traumatic period: 6.6 ± 1.3 (4 - 10) mo.Results. All patients underwent anastomotic urethroplasty. No early postoperative complications were identified. Spontaneous urination was restored by 14 - 15 days in all patients. Early urethral stricture relapses were revealed in 9 (52.9%) patients during 3-mo follow-up. These patients underwent removal of the metal structures fixing the pelvic bones. Repeated urethroplasty was performed a month later. Subsequent relapses of urethral stricture were not detected in any of 17 cases with a median follow-up of 28 (12 - 128) mo.Conclusion. Surgical treatment of urethral strictures associated with a pelvic ring fracture and osteosynthesis is advisable after removal of the metal structures fixing the pelvic bones. This is since the excessed retropubic screws protrusion (> 0.2 - 0.3 mm) is associated with a large area of periurethral fibrous inflammation and causes high relapse risks of stricture disease (52.9%) in the case of urethral surgery preceding the removal of metal structures

Histopathological evaluation of the evolution of oral mucosa grafts used for augmentation urethroplasty

INTRODUCTION: The clinical efficiency of oral mucosa grafts used for augmentation urethroplasty has been proven. However, a small number of studies in literature are dedicated to the determination of pathologic changes in grafts during the engraftment in the urethra. AIM: to assess the histopathologic evolution of oral mucosa graft used for augmentation urethroplasty. MATERIAL AND METHODS: A total of 15 patients aged 19-67 years with penile and combined penile/bulbar urethral strictures of length 3.5-11 cm were undergone to two-staged urethroplasty by Asopa technique. In 9 cases the pathologic study of oral mucosa grafts after sampling (buccal mucosa in 5 cases and lip mucosa in 4 cases) and 6 months after their engraftment in the urethra during the second stage of urethroplasty was performed. In other 6 cases the graft tissue in patients with recurrent stricture that occurred 12-24 months after tubularization and requiring additional intervention was studied. RESULTS: The general structure of mucosal graft was preserved 6 months after sampling. The dystrophic changes in epithelium, inflammatory infiltration and foci of fibrosis in subepithelial layer were observed. Buccal grafts were distinguished by a smaller epithelium thickness and the presence of keratinization foci. The grafts also retained their structure after 12-24 months. A decrease in the severity of chronic inflammatory reaction and the absence of keratinization of the squamous buccal epithelium were found. The stricture in the area of anastomosis was characterized by the presence of sclerotic and fibrous connective tissue covered with urothelium. CONCLUSION: The oral mucosa grafts completely preserve their histologic structure during 1-2 years and they are not involved in recurrence of urethral stricture, which develops in the area of anastomosis between graft and native urethra

Virusuria as a component of the urine microbiota and its significance for assessing the health of the urinary tract: a descriptive clinical study

AIM: To determine the frequency of occurrence of oportunistic pathogenic bacterial flora and viral pathogens in the urine of healthy people with the establishment of the association between them. MATERIALS AND METHODS: 40 healthy sexually active women and men were examined, which are divided by gender into equivalent groups: Group I - healthy women (n=19), Group II - healthy men (n=21). The age of the subjects ranged from 20 to 25 years, the average age was 22.4+/-1.2 years. In both groups, the average portion of morning urine was taken for a study after a proper hygienic procedure with self-urination of the subjects in a sterile plastic container (Sterile Uricol for urine sample collection HiMedia ). In addition to the nutrient media regulated by the Clinical Guidelines, additional HiMedia chromogenic media were used to cultivate facultative anaerobic (FAB) and non-clostridial anaerobic bacteria (NAB). Detection of viruses was performed by PCR with detection in real time . DNA isolation was carried out by the sorption method using the AmpliPrime DNA-Sorb-B ( NextBio ) kit from urine samples, with preliminary concentration. RESULTS: In all 40 cases, normative leukocyturia was detected in the urine. According to the results of bacteriological examination of urine, healthy men and women in all cases found aerobic-anaerobic associations. Coagulase-negative staphylococci (CNS) and Corynebacterium spp. Dominated in the cluster of aerobic taxa of microbiota. (75.0%, 55.0% respectively). The spectrum of CNS was represented by five species: S.epidermidis (30.0%), S.haemolyticus (27.5%), and S.warneri (25.0%), S.saprophyticus and S.lentus (15.0%). Enterococcus spp. were recorded in the urine in 32.5% of cases. Representatives of the Enterobacteriaceae family were represented by 4 taxa: E. coli (10.0%), Klebsiella spp., Proteus spp. (5.0% each), Enterobacter spp., Citrobacter spp. (2.5%). In a cluster of anaerobic bacteria in the urine, Eubacterium spp. (60.0%) and almost half of healthy individuals recorded Lactobacillus spp. and Peptococcus spp. (42.5% each). When analyzing the frequencies of detection of various microbiota taxa, it was found that women significantly more frequently recorded urine Corynebacterium spp., Eubacterium spp. and Lactobacillus spp., as well as Enterococcus spp. and Peptococcus spp. Peptostreptococcus spp. and Veillonella spp. were significantly more often determined (p\u3c0.05) in the urine of men. HHV6 (10.0%), HPV18 and B19 parvovirus (2,5%) were determined in the urine of healthy people. It should be noted that the studied viruses were more often recorded in men, in particular, HPV18 and parvovirus B19 - only in men, and HHV6 more often in men (7.5%), less often in women (2.5%). Significant associations of some genera of microorganisms with the sex of the participants were revealed for E. faecalis and Lactobacillus spp., which were more often found in the urine of healthy women Reliably significant associations were found for three taxa: viruses HPV6, HPV18 and parvoviruses B19 (16.7%) were determined in the presence of Bacteroides spp., Bifidobacterium spp., and Prevotella spp., in urine. Accordingly, in 83.3% of cases, these viruses were detected in the absence of the above-listed taxa of microorganisms in the urine. CONCLUSIONS: The normal urinary microbiota of healthy women and men has differences: Lactobacillus spp and Candida spp are absent in the urine of men while Streptococcus spp in urine of women. HHV6, HPV18, parvoviruses B19 are found in urine of healthy people and more often in men. Data about the virobiota and microbiota of urine in healthy people can highlight on the pathogenesis of urinary tract infections of various localization and develop targeted approaches in personalized therapy of this group of diseases

Stable Deuterium Labeling of Histidine-Rich Lysine-Based Dendrimers

Peptide dendrimers, due to their biocompatibility and low toxicity, are highly promising candidates as nanocarriers for drugs and genes. The development of this kind of delivery system requires reliable monitoring of their metabolic and biological pathways. In this respect, hydrogen isotope labeling has tremendous importance, being a safe tool for detection of the labeled nanocarriers. In this work, we have synthesized new histidine-rich lysine-based dendrimers (Lys-2His dendrimer) with two linear histidine (His) residues in every inner segment. The presence of His residues has enabled us to perform controlled deuteration of Lys-2His dendrimers. The high deuteration degree (around 70%) does not practically change after redissolving the samples in H2O and heating them at 40 °C, which indicates the isotopic label stability