[Complications of transnasal endoscopic orbital decompression in thyroid eye disease]. / Oslozhneniya transnazal'noi endoskopicheskoi dekompressii orbity pri endokrinnoi oftal'mopatii.

PURPOSE: The study evaluates the frequency of complications after transnasal endoscopic orbital decompression (TEOD). MATERIAL AND METHODS: The study included 40 patients (75 orbits) with thyroid eye disease (TED; also termed Graves' ophthalmopathy, GO; thyroid-associated orbitopathy, TAO), who were divided into three groups depending on the method of surgical treatment. The first group consisted of 12 patients (21 orbits) who were treated with TEOD as the only method of surgical treatment. In the second group, there were 9 patients (18 orbits) who underwent TEOD and lateral orbital decompression (LOD) simultaneously. The third group consisted of 19 patients (36 orbits) who underwent TEOD as the second stage after LOD. Pre- and postoperative observation included assessment of visual acuity, visual field, exophthalmos, heterotropia/heterophoria angle. RESULTS: In group I the new-onset strabismus with binocular double vision was detected in 1 patient (8.3%). In 5 patients (41.7%), there was an increase in the angle of deviation and an increase in diplopia. In group II the new-onset strabismus with diplopia occurred in 2 patients (22.2%). In 8 patients (88.9%), an increase in the angle of deviation and an increase in diplopia were revealed. In group III the new-onset strabismus and diplopia occurred in 4 patients (21.0%). An increase in the deviation angle and an increase in diplopia were noted in 8 patients (42.1%). The number of postoperative otorhinolaryngologic complications in group I was 4 (19.0% of the number of orbits). Two intraoperative complications were recorded in group II - 1 case of cerebrospinal rhinorrhea (5.5% of the number of orbits) and 1 case of retrobulbar hematoma without permanent vision loss (5.5% of the number of orbits). The number of postoperative complications was 3 (16.7% of the number of orbits). In group III the number of postoperative complications was 3 (8.3% of the number of orbits). CONCLUSION: The study showed that the most common ophthalmological complication after TEOD is strabismus with binocular double vision. Otorhinolaryngologic complications included synechiae of the nasal cavity, sinusitis and mucocele of the paranasal sinuses.

[Prospective comparison of cognitive and mpMR/US fusion biopsy for prostate cancer detection].

INTRODUCTION: According to the recommendations of the European Association of Urology the presence of a suspicious lesion on MRI is an indication for both primary and secondary MR-targeted biopsies. At the same time, the Russian Society of Urologists recommends to perform mpMR/US fusion biopsy only in patients with a prior negative biopsy. In clinical practice, mpMR/US fusion and cognitive biopsies are the most frequently performed. However, when comparing them, contradictory data on detection of clinically significant prostate cancer is obtained. OBJECTIVE: to compare the detection rate of clinically significant prostate cancer performing cognitive and mpMR/US fusion biopsies. MATERIALS AND METHODS: Inclusion criteria: PSA >2 ng/mL and/or a positive DRE, and/or a suspicious lesion on TRUS, and PI-RADSv2.1 lesion more or equal 3. At first, "unblinded" urologist performed a transperineal mpMR/ultrasound fusion and saturation biopsy. Then "blinded" urologist obtained transrectal cognitive biopsy Clinically significant cancer was defined as ISUP more or equal 2. RESULTS: We enrolled 96 patients. Median age was 63 years, prostate volume - 47 cm3 and PSA - 6.82 ng/mL. MpMR/US fusion and cognitive biopsies were comparable in regard to the detection rate of clinically significant (32.3% vs 25.0%; p=0.264), clinically insignificant cancer (25.0% and 26.0%; p=0.869) and overall detection rate (57.3% and 51%;p=0.385). Both biopsies missed clinically significant cancer with equal frequency (5.2%; p=0.839). Histological efficacy also was comparable. The number of positive cores between mpMR/US fusion and cognitive biopsy was equal (34.1% and 31.1% respectively; p= 0.415). At the same time, no statistically significant difference was found with respect to maximum cancer core length (53.1% vs 47.7%, respectively; p=0.293). CONCLUSION: The results suggest that both cognitive and mpMR/US fusion biopsies are equally accurate diagnostic methods for clinically significant prostate cancer detection, thus their wider introduction into clinical practice is necessary.

[Ophthalmic complications of endoscopic sinus surgery]. / Oftal'mologicheskie oslozhneniya endoskopicheskikh operatsii na pridatochnykh pazukhakh nosa.

Endoscopic surgery of the accessory nasal sinuses (ANA) is widely used as the main treatment method for ANA diseases. It is a well-proven, safe and effective method. However, occasionally certain complications may occur. Ophthalmic complications are rare but can lead to irreversible changes. Anatomical organization of the orbit and paranasal sinuses contributes to the risk of damaging the eye ball and its appendages. During endoscopic sinus surgeries, lamina papyracea of the ethmoid bone, extraocular muscles, the optic nerve and the lacrimal passages can be damaged. Ophthalmic complications are classified as non-significant, significant and severe. Studying the data obtained with multi-slice computed and/or magnetic resonance tomography and the patient's medical history during the preoperative stage is necessary in order to minimize the risk of such complications, as well as monitoring the clinical data during all stages of treatment.

Carbon nanotubes for polarization sensitive terahertz plasmonic interferometry.

We report on helicity sensitive photovoltaic terahertz radiation response of a carbon nanotube made in a configuration of a field-effect transistor. We find that the magnitude of the rectified voltage is different for clockwise and anticlockwise circularly polarized radiation. We demonstrate that this effect is a fingerprint of the plasma waves interference in the transistor channel. We also find that the presence of the helicity- and phase-sensitive interference part of the photovoltaic response is a universal phenomenon which is obtained in the systems of different dimensionality with different single-particle spectrum. Its magnitude is a characteristic of the plasma wave decay length. This opens up a wide avenue for applications in the area of plasmonic interferometry.

[Functional multislice computed tomography of the orbits in diagnosis of incomitant strabismus]. / Funktsional'naya mul'tispiral'naya komp'yuternaya tomografiya orbit v algoritme diagnostiki nesodruzhestvennykh form kosoglaziya.

PURPOSE: To study the value of functional multislice computed tomography (MSCT) of the orbits in examination of patients with complex incomitant strabismus. MATERIAL AND METHODS: The study included 34 patients. In 8 (23.5%) out of 34 patients, strabismus occurred as the result of an orbital injury. In some patients, incomitant strabismus was a complication of: retrobulbar injection of drugs (4 cases (11.7%)); endoscopic sinus surgery (6 cases (17.6%)); reconstructive surgery of orbits (7 cases (20.6%)). In 9 cases (26.5%), incomitant strabismus was detected in patients with thyroid eye disease (TED), of them 5 (14.7%) had previously undergone balanced orbital decompression (BOD). All patients underwent functional MSCT of the orbits. RESULTS: Complete absence of the contractile function of the studied muscles was noted in 6 cases with loss of ocular motility in one or several directions of gaze. Contraction of the injured muscle and its fixation in the area of iatrogenic defect in the orbital wall was observed in 6 patients with severe limitation of ocular motility. limitation of the excursion of the inferior and/or medial rectus muscles due to their fixation in the fracture of the orbital wall was observed in 5 patients after orbital trauma. Signs of contracture of the inferior rectus muscle were revealed in 4 cases of strabismus that occurred after retrobulbar anesthesia. Pronounced increase in the lateral dimensions of the extraocular muscles was determined in 4 patients with TED, as well as in patients who had underwent BOD. Displacement of the lateral and medial rectus muscles into the formed bony windows with a change in the vector of their action was observed in patients who had underwent BOD. CONCLUSION: The data obtained with functional MSCT of the orbits in 34 patients allowed more accurate characterization of the oculomotor disorders and evaluation of the functional state of the extraocular muscles.

Distinction between electron states formed at topological insulator interfaces with the trivial phase and vacuum.

In this paper, we show that electron states formed in topological insulators at the interfaces topological phase-trivial phase and topological phase-vacuum may possess different properties. This is demonstrated on an example of heterostructures based on thick topological Hg1-xCdxTe films, in which the PT-symmetric terahertz photoconductivity is observed. It is shown that the effect originates from features of the interface topological film-trivial buffer/cap layer. The PT-symmetric terahertz photoconductivity is not provided by electron states formed at the interface topological film-vacuum.

[Retrobulbar hematoma in endoscopic endonasal dacryocystorhinostomy]. / Retrobul'barnaya gematoma pri endoskopicheskoi endonazal'noi dakriotsistorinostomii.

Recently, an increase in the number of operations on the lacrimal ducts performed by otorhinolaryngologists has been noted throughout the world. During these operations, intra- and postoperative complications may develop, which require the intervention of an ophthalmologist. A rare complication of endoscopic dacryocystorhinostomy is the development of retrobulbar hemorrhage. This article presents a clinical case of the development of retrobulbar hemorrhage in endoscopic dacryocystorhinostomy. The patient with dacryocystitis underwent endoscopic dacryocystorhinostomy. Preoperative computed tomography revealed a lack of bone tissue in the lacrimal sac fossa. Severe bleeding was noted during the operation. Against the background of tamponade of the formed anastomosis, a growing exophthalmos, conjunctival chemosis, subconjunctival hemorrhage were noted. After removing the tampon, a positive trend was noted. Dexamethasone solution was intraoperatively intravenously administered, in the postoperative period - methylprednisolone solution. According to computed tomography data, exophthalmos persisted on the first day after the operation, hematoma was localized. Visual functions are unchanged. Six months after the operation, the patient had no complaints. According to the computed tomography data, a functioning dacryorhinostomy anastomosis was determined. Often, an interdisciplinary approach to such complications is required, since it can provide full orbital decompression, as well as adequate postoperative management of the patient, which contributes to the most complete ophthalmic rehabilitation. The interaction of otorhinolaryngologists and ophthalmologists in such cases is an indispensable condition for the safety of the operation.

Non-local terahertz photoconductivity in the topological phase of Hg1-xCdxTe.

We report on observation of strong non-local photoconducitivity induced by terahertz laser pulses in non-zero magnetic field in heterostructures based on Hg1-xCdxTe films being in the topological phase. While the zero-field non-local photoconductivity is negligible, it is strongly enhanced in magnetic fields ~ 0.05 T resulting in appearance of an edge photocurrent that exceeds the respective dark signal by orders of magnitude. This photocurrent is chiral, and the chirality changes every time the magnetic field or the electric bias is reversed. Appearance of the non-local terahertz photoconductivity is attributed to features of the interface between the topological film and the trivial buffer.

[Phenotyping of angiotensin-converting enzyme in the prostate in patients with prostate cancer and benign prostatic hyperplasia].

BACKGROUND: Angiotensin-converting enzyme (ACE) is expressed by all epithelial cells of the human body. Although the main proportion of ACE is synthesized by the lungs, in men, ACE is also secreted by the testes (testicular form), seminal vesicles and the prostate. In semen, the level of ACE is up to 50 times higher than in blood plasma. The substitution of highly specific epithelial cells of the prostate by tumor cells causes a dramatic decrease in ACE production by the prostate cells. AIM: To assess the possibility of using prostatic ACE as a new marker of prostate cancer (PCa). MATERIALS AND METHODS: ACE phenotyping in prostate of patients with PCa and benign prostatic hyperplasia (BPH) included measurement of the activity of two ACE substrates (HHL and ZPHL); calculation of the ratio of their hydrolysis rates (ZPHL/HHL ratio); quantitative assessment of the ACE immunoreactive protein, the ratio of the immunoreactive protein to the ACE activity, as well as the conformation of ACE using a panel of monoclonal antibodies (mAb) to different epitopes of ACE. RESULTS: ACE activity in tumor cells was markedly reduced and the ratio of immunoreactive ACE to its activity increased. The ratio of the hydrolysis rates of two substrates (ZPHL/HHL ratio) in patients with PCa increased compared to control group, while it was not observed in the vast majority of patients with BPH. There were several tissue samples with a histological diagnosis of BPH, but ACE phenotype was typical for PCa. DISCUSSION: Since a decrease in ACE activity was found in all patients with PCa, we suggest that it may serve as a reliable and early marker of the tumor development. Changes in the ACE phenotype, which are typical for PCa, but found in patients with BPH, may indicate earlier malignant changes in prostate cells, which are not visible on routine prostate biopsy. CONCLUSIONS: ACE activity and its conformation in prostatic biopsies has the potential to be an early biomarker or a differential criterion for PCa. In PCa, the ACE activity in the prostate is significantly reduced, and the ZPHL/HHL ratio is markedly increased in comparison to control group. However, there were no such changes in patients with BPH. In hyperplastic processes of the prostate (BPH, PCa), there is a change in ACE sialylation, which is accompanied by an increase in the binding of ACE to mAb 3F10 compared to the control group. Patients with negative biopsy result, but properties of prostate ACE, which are typical for PCa, require close follow-up, since they may have an increased risk of subsequent developing PCa. However, due to a small sample of patients, the diagnostic potential of prostate ACE for PCa and BPH requires to be validated in a larger number of patients to confirm its predictive accuracy.

[Strabismus and oculomotor disorders induced by injection anesthesia for cataract surgery]. / Kosoglazie i glazodvigatel'nye narusheniya, indutsirovannye in"ektsionnoi anesteziei v khirurgii katarakty.

PURPOSE: To analyze diagnostic and treatment outcomes in patients with strabismus and oculomotor disorders induced by injection anesthesia for cataract surgery. MATERIAL AND METHODS: The study included 11 patients (7 women and 4 men) aged 61 to 85 years (the mean age of 66±7.1 years) who complained of diplopia in the early post-op period after cataract phacoemulsification and elastic IOL implantation under retrobulbar anesthesia. Prior to further surgical treatment, all of the patients underwent functional multispiral computer tomography of the orbits. Prismatic spectacle correction was also used independently or in addition to surgical treatment. RESULTS: Eight out of eleven patients underwent one- or two-step surgical treatment (3 and 5 cases, respectively). In 2 patients, hypotropia did not exceed 10 prism diopters, and thus, diplopia could be compensated with prismatic spectacle correction alone. In 5 cases, binocular vision was achieved throughout the whole field of gaze. In 3 cases, surgical treatment enabled elimination of heterotropia in the primary gaze and compensation of diplopia within a radius of 40º from the center of gaze and within the entire horizontal range of eye-movement in the downward gaze. The limitation of ocular mobility decreased from 2.36 to 0.55 points leading to an associated decrease in the area of binocular diplopia - from 98% to 29%. In one case, spectacle occlusion was used. CONCLUSION: The inferior rectus restriction is the morphological substrate of anatomical and functional changes induced by retrobulbar anesthesia. As treatment options for restrictive vertical strabismus and binocular diplopia, both surgical (extraocular muscle surgery) and optical (prismatic correction, occlusion) methods should be considered.

[Neurotization of the cornea as pathogenically targeted method of treating neurotrophic keratitis in patients with facial paralysis]. / Nevrotizatsiya rogovitsy kak patogeneticheski napravlennyi metod lecheniya neirotroficheskogo keratita u patsientov s litsevym paralichom.

Combined lesions of the facial and trigeminal cranial nerves are typical after neurosurgical treatment. Violation of the innervation of orbicularis muscle leads to inability to completely close the eyelids, while denervation of the cornea is often manifested as a long-term ongoing and recurring neurotrophic keratitis. The restoration of corneal innervation is a pathogenetically targeted treatment for this pathology. For this purpose, neurotrophic keratitis could be reversed via the method of corneal neurotization using contralateral n. ophthalmicus. The presented clinical case demonstrates the results of the first operation of neurotization of the cornea in a patient with combined lesions of the facial and trigeminal nerves.

Apparent PT-symmetric terahertz photoconductivity in the topological phase of Hg1-xCdxTe-based structures.

We show that the terahertz (THz) photoconductivity in the topological phase of Hg1-xCdxTe-based structures exhibits the apparent PT- (parity-time) symmetry whereas the P-symmetry and the T-symmetry, separately, are not conserved. Moreover, it is demonstrated that the P- and T-symmetry breaking may not be related to any type of the sample anisotropy. This result contradicts the apparent symmetry arguments and means that there exists an external factor that interacts with the sample electronic system and breaks the symmetry. We show that deviations from the ideal experimental geometry may not be such a factor.

[Strabismus surgery and anterior segment ischemia syndrome]. / Khirurgiia kosoglaziia i sindrom ishemii perednego segmenta glaza.

The review summarizes the results of studies related to ischemia of the anterior segment of the eye after surgeries on straight extraocular muscles for strabismus and presents classification, clinical manifestations and risk factors for the development of the syndrome. The principal prevention measures for the clinically significant syndrome are focused on limiting the extent of surgical intervention: in the presence of risk factors and the need for intervention on more than two muscles - staged surgical treatment (i.e. ensuring a time interval between surgeries) that allows collateral circulation to form properly.

[Posttraumatic orbital defect correction with bone autografts]. / Ustranenie posttravmaticheskikh defektov glaznitsy s primeneniem kostnykh autotransplantatov.

The aim of the study was the assessment of safety of posttraumatic orbital defect correction with bone autografts. The study comprised 69 patients divided in 2 groups: 21 patients with isolated orbital floor and medial wall deformities and 48 patients with complex midface injuries. Membranous bone autografts were used for deformities correction along with soft tissues hypercorrection with a mix of bone chips and platelet rich plasms. The paper presents diagnostic algorithm for orbital trauma patients. Correction of complex midfacial injuries in group 2 resulted in restricted ocular mobility and increase in diplopy square. Subciliary approach caused lower lid retraction deteriorating esthetic results of the surgery. Ocular vessels hemodynamics showed improvement 1 year after surgery.

Detection of pulsed blood flow through a molar pulp chamber and surrounding tissue in vitro.

OBJECTIVES: Due to severe limitations of dental pulp sensitivity tests, the direct recording of pulsed blood flow, using photoplethysmography (PPG), has been proposed. In vivo evaluation is methodologically difficult and in vitro models have hitherto been adversely influenced by shortcomings in emulating the in vivo situation. Consequently, the aim of this study was to test an improved data acquisition system and to use this configuration for recording pulsed blood in a new model. MATERIALS AND METHODS: We introduced a PPG signal detection system by recording signals under different blood flow conditions at two wavelengths (625 and 940 nm). Pulsed blood flow signals were measured using an in vitro model, containing a molar with a glass pulp and a resin socket, which closely resembled in vivo conditions with regard to volumetric blood flow, pulp anatomy, and surrounding tissue. RESULTS: The detection system showed improved signal strength without stronger blanketing of noise. On the tooth surface, it was possible to detect signals emanating from pulsed blood flow from the glass pulp and from surrounding tissue at 625 nm. At 940 nm, pulp derived signals were recorded, without interference signals from surrounding tissue. CONCLUSION: The PPG-based method has the potential to detect pulsed blood flow in small volumes in the pulp and (at 625 nm) also in adjacent tissues. CLINICAL RELEVANCE: The results show the need for clear differentiation of the spatial origins of blood flow signals of any vitality test method to be applied to teeth.

[Clinical manifestations of orbital lesion in granulomatosis with polyangiitis]. / Klinicheskie proiavleniia porazheniia orbity pri granulematoze s poliangiitom.

One of the most common and potentially threatening manifestations of granulomatosis with polyangiitis (GPA) is orbital lesion. PURPOSE: To study the clinical course and prognosis of orbital lesions of various localization in GPA patients. Material and me-thods. The study included 226 patients with GPA, 74 of them with orbital lesion. Ophthalmic examination consisted of visual acuity test, biomicroscopy, ophthalmoscopy, exophthalmometry and ocular mobility test. Visualization was done using multislice computed tomography and/or magnetic resonance tomography and/or ultrasound examination. RESULTS: Among the patients of the study group, in 35.1% the lesion was limited to dacryoadenitis, in 4.0% of patients - to myositis, and 70.8% had extensive inflammatory orbital masses. Patients with orbital masses had systemic disease in 51.1%, compared to 7.7% in dacryoadenitis (p=0.00). Clinical progression in patients with orbital masses was characterized by severe exophthalmos, periorbital swelling and hyperemia. Patients with dacryoadenitis, on the contrary, had only mild symptoms. Patients with orbital masses had unfavorable prognosis. There were only three patients with myositis in the study group, so the data on them is limited; their clinical symptoms included light periorbital swelling, exophthalmos, strabismus, painful binocular diplopia and eye movement restriction. The disease was recurring in two cases. CONCLUSION: Patients with orbital involvement in GPA may have different course of the disease depending on the localization of inflammation.

[Hyaluronic acid gel implants for correction of pathological conditions of the orbit and eyelids]. / Primenenie in''ektsionnykh implantatov na osnove gelia gialuronovoi kisloty pri patologii vek i orbity.

PURPOSE: To evaluate the effectiveness of injectable implants made of hyaluronic acid gel (HAG) in ophthalmoplastics. MATERIAL AND METHODS: The study included 57 patients (37 patients with lagophthalmos related to acute or chronic facial nerve palsy, endocrine ophthalmopathy; 20 patients with enophthalmos, anophthalmic syndrome). Depending on filler particle size, the patients received either intrapalpebral or intraorbital HAG injection. The biometric measures of palpebral fissure, the position of the eye/implant, and the condition of the cornea were evaluated during the follow-up period (12 months for eyelid and 18 for orbital injection). RESULTS: In the course of the follow-up, all patients showed reliable reduction of lagophthalmos; additionally, improvement of the condition of the cornea was observed in patients after intrapalpebral injection; patients after intraorbital injection exhibited reduction in enophthalmos, upper orbital palpebral fold retraction and upper eyelid excursion. No serious complications have occurred after the injection. CONCLUSION: As minimally invasive method of treating various pathologies of the orbit and eyelids, HAG fillers showed good clinical effectiveness and safety.

[En bloc holmium laser enucleation of the prostate (HOLEP EN BLOC): our experience].

INTRODUCTION: Some authors consider HoLEP a new gold standard for the surgical management of prostatic hyperplasia. The increasing utilization of holmium enucleation has led to the development of various modifications of this treatment modality, including the so-called enucleation as a single piece (HoLEP en bloc), which reduces the operative time and, according to some authors, facilitates acquiring new surgical technique by surgical trainees. AIM: To compare the effectiveness and safety of the traditional HoLEP and HoLEP en bloc. MATERIALS AND METHODS: The study comprised 227 BPH patients aged from 53 to 86 years old (mean - 61.38+/-5.09 years). HoLEP en bloc was performed in 114 patients, of whom 39 patients had prostate volume (Vpr) less than 80 cm3, and in 75 patients it was more than 80 cm3. The standard HoLEP was performed in 113 patients, of whom 41 patients had Vpr less than 80 cm3, and in 72 patients it was more than 80 cm3. RESULTS: Enucleation time: HoLEP - 48+/-12 min, HoLEP en-bloc - 35+/-10; morcellation time: HoLEP - 20+/-3 min, HoLEP en-bloc - 16+/-12; duration of urinary bladder drainage by a urethral catheter: HoLEP - 58+/-3 h, HoLEP en-bloc - 41+/-2; length of hospital stay: HoLEP - 5.93+/-0.39 days, HoLEP en-bloc - 4.45+/-0.35; bladder tamponade, urethrocystoscopy and coagulation of bleeding vessels: HoLEP-3, HoLEP en-bloc-1; infectious-inflammatory complications (prostatitis): HoLEP-3, HoLEP en-bloc-2; acute urinary retention, stress urinary incontinence: HoLEP-6, HoLEP en-bloc-2; stress urinary incontinence: HoLEP - 5, HoLEP en-bloc - 2. CONCLUSION: En bloc holmium enucleation of the prostate results in the reduction of enucleation and total operative time compared with traditional HoLEP due to the fast identification of the surgical capsule and the right layer. Using this technique can improve the effectiveness of learning holmium laser enucleation of the prostate by surgical trainees.

[Complications of the holmium laser enucleation of prostate for benign prostatic hyperplasia].

INTRODUCTION: With growing experience in the HoLEP, it can replace TURP as the "gold standard" for the surgical management of BPH, and therefore this technique is the most studied surgical modality. Despite the proven effectiveness of HoLEP in the treatment of patients with BPH, its widespread use has been associated with both intra- and postoperative complications. AIM: To improve the results of surgical management of patients with BPH. MATERIAL AND METHODS: The study comprised 310 patients who underwent HoLEP for BPH. HoLEP was performed using the Gillings technique. INCLUSION CRITERIA: presence of LUTS (Qmax<15 ml/s, Qav<10 ml/s, presence of residual urine, I-PSS score> 5, QoL score> 2), absence of an active inflammatory process of the urogenital organs. RESULTS: Intraoperative complications included severe hemorrhage in 16 (5.2%), the bladder wall injury in 17 (5.5%) and the ureteral orifice injury in 2 (0.6%) patients. 275 (88.7%) had no intraoperative complications. Early postoperative complications included fever in 4 (1.3%), the bladder tamponade that required cystoscopy and evacuation of blood clots in 7 (2.3%) and acute urinary retention in 36 (11.8%) patients. 263 (84.6%) patients had no postoperative complications. Long-term postoperative complications comprised urinary incontinence in 39 (12.6%) patients and urethral strictures requiring surgical treatment in 9 (2.9%) patients. There were no long-term complications in 262 (84.5%) patients. CONCLUSION: HoLEP is an effective and safe surgical modality for treating patients with BPH with minimal complications, suitable for any size of the prostate.

[Conformational Fingerprinting Using Monoclonal Antibodies (on the Example of Angiotensin I-Converting Enzyme-ACE)].

During the past 30 years my laboratory has generated 40+ monoclonal antibodies (mAbs) directed to structural and conformational epitopes on human ACE as well as ACE from rats, mice and other species. These mAbs were successfully used for detection and quantification of ACE by ELISA, Western blotting, flow cytometry and immunohistochemistry. In all these applications mainly single mAbs were used. We hypothesized that we can obtain a completely new kind of information about ACE structure and function if we use the whole set of mAbs directed to different epitopes on the ACE molecule. When we finished epitope mapping of all mAbs to ACE (and especially, those recognizing conformational epitopes), we realized that we had obtained a new tool to study ACE. First, we demonstrated that binding of some mAbs is very sensitive to local conformational changes on the ACE surface-due to local denaturation, inactivation, ACE inhibitor or mAbs binding or due to diseases. Second, we were able to detect, localize and characterize several human ACE mutations. And, finally, we established a new concept - conformational fingerprinting of ACE using mAbs that in turn allowed us to obtain evidence for tissue specificity of ACE, which has promising scientific and diagnostic perspectives. The initial goal for the generation of mAbs to ACE 30 years ago was obtaining mAbs to organ-specific endothelial cells, which could be used for organ-specific drug delivery. Our systematic work on characterization of mAbs to numerous epitopes on ACE during these years has lead not only to the generation of the most effective mAbs for specific drug/gene delivery into the lung capillaries, but also to the establishment of the concept of conformational fingerprinting of ACE, which in turn gives a theoretical base for the generation of mAbs, specific for ACE from different organs. We believe that this concept could be applicable for any glycoprotein against which there is a set of mAbs to different epitopes.