[Non-neurogenic activators of myocyte contraction and their role in the realization of the accumulative-evacuating functions of the urinary bladder].

The search for and use of alternative biomarkers of the hyperactive bladder has garnered increasing attention in recent years because they may be considered pathogenetically significant and used as surrogate biomarkers. Promising agents that have met these criteria include proteins cytokines, neurotrophins, tumor necrosis factor (TNF), nerve growth factor (NGF), fibrinopeptides A and B, C-reactive protein, membrane-bound ATPase. Analysis of current scientific literature has demonstrated that specialists in many fields of medicine show interest in endogenous proteins that do not belong to neurotransmitters but affect the contractile ability of myocytes. The presented data indicate the feasibility and prospects of their use, but further studies and evaluation are needed. Based on the present literature review, the authors conclude that endogenous proteins activating myocyte contractility are of great clinical value as promising markers for detecting detrusor overactivity, its severity, and evaluation of the treatment effectiveness. The authors suggest that proteins of this group can play an important role not only in the pathogenesis of bladder function disorders but also in the physiological process of urination as an additional non-neurogenic humeral component.

[Homeostatic and antioxidant defense enzymes activity in chronic pyelonephritis]. / Pokazateli gomeostaza i funktsional'noe sostoianie fermentov antioksidantnoi zashchity pri khronicheskom pielonefrite.

As shown by the analysis of chronic pyelonephritis, manifestations in patients with high and low activity of antioxidant system enzymes, patients with high catalase activity have more effective defense of red cells, glomerular epithelium. This was concluded from marked differences in urinary excretion of metabolites, hemoglobin levels compared to those in patients with low activity of catalase. In low activity of glutathione peroxidase, inflammation gains activity, nonspecific resistance weakens, excretion of some metabolites inhibits vs patients with high activity of this enzyme. The data provide criteria for diagnosis of antioxidant system defects and show necessity of antioxidant drugs inclusion into the therapeutic scheme (unitiol, antioxidant complex of vitamins A, E, C, P).

[Membranous aspects of kidney transplantation and reasons of transplant antioxidant defense]. / Membranologicheskie aspekty peresadki pochki i obosnovanie antioksidantnoi zashchity transplantanta.

Special membranological studies of the role of antioxidant emoxipine in combined pharmacological support of stable function of the transplanted kidney in 30 patients have shown that this drug restores phospholipid pool of red cell membranes and improves their physical properties. No significant fluctuations of cyclosporin A blood concentrations were registered. Emoxipine addition to combined therapy of patients with transplanted kidney is recommended.

[Endovascular Helium-Neon laser irradiation of the blood in the treatment of chronic pyelonephritis]. / Endovaskuliarnoe obluchenie krovi gelii-neonovym lazerom bol'nykh khronicheskim pielonefritom.

The authors analyze the condition of free-radical oxidation and activity of antioxidant system, clinical effectiveness of He-Ne laser therapy of patients with chronic pyelonephritis. It is shown that clinical manifestation of the disease is accompanied with activation of free radical oxidation and hypoactivity of antioxidant system. Endovascular laser hemotherapy stimulates antioxidant system, activity of superoxide dismutase, in particular. A good response and immunomodulation are achieved.

[Essential phospholipids in the treatment of chronic pyelonephritis]. / Essentsial'nye fosfolipidy v lechenii khronicheskogo pielonefrita.

The author's investigations led them to the conclusion that clinical manifestation of chronic pyelonephritis is associated with destabilization of lipid bilayer of red cell membranes, renal tissue, activation of lipid peroxidation (LPO), rising lipid and LPO products excretion with the urine. 31 patients with chronic pyelonephritis received combined therapy comprising essential phospholipids. 25 control patients with the same disease were not given essentiale-forte. Finally, the latter had longer fever duration, more active inflammation. The former had also low urine excretion of oxalates and normal lipid composition of biological membranes.

[The role of autonomous flora in the realization of manifest forms of urinary tract infection]. / Rol' autoflory v realizatsii manifestnykh form infektsii mochevykh putei.

The investigations done showed that autoflora migrates from the intestinal reservoir into different organs and tissues passing through the injured surface, urinary tracts. Injury to the tissue structures results in derangement of the mechanisms of transmembranous transport, sedimentation of autoflora in the focal lesions, with the ensuing clinical manifestation of the illness being readily recordable. Location of the focal lesion, share that the autoflora has in the inflammatory reaction of the macroorganism, is most important stage-removing the injured tissues and subsequent regeneration. It is the immune system that controls this process.

[Membrane-destabilizing processes as the universal basis of inflammation]. / Membranodestabiliziruiushchie protsessy kak universal'naia osnova vospaleniia.

It is established that active pyelonephritis and operative stress are accompanied with structural and functional changes in erythrocytic membranes: cholesterol and its ethers rose in quantity as well as difficulty oxidized phospholipids, cation adenosine triphosphatase activity changed. Being nonspecific, these changes seemed more pronounced in the active phase of chronic pyelonephritis. Minor structural rearrangement of membrane lipids in surgical patients indicated uneventful postoperative period. It is suggested that bacterial inflammation in the kidneys and urinary tracts may be related to the above shifts. The adjuvant use of dimephosphone produced a clear-cut membrane-stabilizing effect clinically reflected by reduced inflammation and improved renal function.

[Autogenous infections in the development of postoperative complications]. / Znachenie autogennogo infitsirovaniia v razvitii posleoperatsionnykh oslozhnenii.

The authors studied the mechanisms of bacterial dissemination in operative wounds in patients after various surgical interventions. It was demonstrated in experiments that during adaptation of the organism to the operative stress, autobacteria enter the blood from the intestinal reservoir and are eliminated through the urinary tract and wound surfaces, if foci of mechanical or toxic destruction exist the autobacteria precipitate in the affected tissues and participate directly in the reparative processes. On the basis of the obtained data it is suggested that the phenomenon of activation and persistence of endogenous microflora exists as one of the syndromes of adaptation of man to the aggression factor, which is aimed at revealing and removing the foci of tissue destruction developing as the result of exposure to the effect of the stress.

[Asymptomatic bacteriuria as the manifestation of a syndrome of the activation and persistence of endogenous microflora in dynamic human adaptation to stress]. / Bessimptomnaia bakteriuriia kak proiavlenie sindroma aktivatsii i persistentsii éndogennoi mikroflory v dinamike adaptatsii cheloveka k stressu.

The analysis has been performed of the mechanisms underlying the origin of asymptomatic bacteriuria as an adaptive reaction in response to surgical aggression. The experiments proved penetration of autobacteria from the intestine to blood channel and organic structures of the animals in the course of adaptation to an operative trauma and consequent elimination of the bacteria from the body. It was observed that endogenic microflora participates in regeneration of macroorganism structures which have lost their morphofunctional integrity due to mechanic and toxic aggression. It is suggested that activation and persistence of endogenic microflora may arise to identify and abolish foci of aseptic destruction during the aggression in adaptation to stress.

[The enzyme function of cationic transmembrane transport and its relationship to the homeostatic indices of patients with chronic pyelonephritis]. / Funktsional'noe sostoianie fermentov kationnogo transmembrannogo transporta i ikh vzaimosviaz' s nekotorymi pokazateliami gomeostaza u bol'nykh khronicheskim pielonefritom.

The paper examines the relationship between the clinical manifestations of pyelonephritis and the functional activity of enzymes of cation transmembrane erythrocyte transport (Mg(2+)-, N(+)-K(+)-, Ca(2+)-ATPases). An individual analysis ascertained that the patients who showed a low Ca(2+)-ATPase activity had marked signs of inflammation in the body, as evidenced by ESR, seromucoid and fibrinogen concentrations. These patients had more significantly depressed immune defense mechanisms as reflected by the levels of immunoglobulins, T-lymphocytes, complement, the neutrophil phagocytosis, and urinary IgA concentrations). Variations were also found in examining the excretion of a number of metabolites. There was a substantial decrease in urea, creatinine, titrated acid, phosphorus excretions in patients with deficient Ca(2+)-ATPase activity than in those with its high activity. It was concluded that there was a relationship between some clinical manifestations of pyelonephritis and the functional activity of enzymes of cation transmembrane transport. To treat metabolic disorders, membrane-protective agents are recommended to include into combined therapy.

[Role of structuro-functional changes in cell membranes in the formation of the immune response in patients with chronic pyelonephritis]. / Rol' strukturno-funktsional'nykh izmenenii kletochnykh membran v formirovanii immunnogo otveta u bol'nykh khronicheskim pielonefritom.

The authors analyze the status of cationic transmembranous transport in leukocytes in patients with chronic secondary pyelonephritis (CPN) as related to the clinical manifestations of pathology and immune response. 117 patients with CPN were examined. In 58 patients, pyelonephritis was associated with nephrolithiasis, in 59 with different abnormalities of the kidneys and urinary tract. The immunity status was examined according to the content of IgA, IgG, IgM, T and B lymphocytes, complement (CH50), the phagocytic neutrophil test and secretory IgA in the urine. In white blood cells, a study was made of the activity of Mg(2+)-, Na(+)-K(+)-, Ca(2+)-ATPases. As a result of the studies the patients were found to have low functional activity of Ca(2+)-ATPase, Na(+)-K(+)-ATPase during the clinical manifestations of pyelonephritis. Analysis of the frequency of enzymatic activity values showed their nonuniformity. In some patients, it was lowered (less than X--1), whereas in others, it appeared increased (over X+1). Patients with an enzymatic activity below X--1 manifested a decrease of the content of IgA, IgG, IgM, T and B lymphocytes, and of phagocytic activity of neutrophils as compared to patients exhibiting a high enzymatic activity. The conclusion is made about the relationship between enzymatic function and immune response. It is recommended that drugs possessing membrane-protective and reparative pharmacological effects be included into multimodality therapy.