Endogenous Regeneration of Alveolar Bone by Decellularized Tooth Matrix.

The efficiency of bone tissue regeneration by decellularized tooth matrix, demineralized tooth matrix, and commercial xenograft Bio-Oss Spongiosa was compared on the model of a critical-size circular defect in the alveolar bone of the upper jaw of adult Wistar rats. The defect healing dynamics was assessed using histological, histomorphometrical, and immunohistochemical methods on days 30 and 60. In contrast to demineralized matrix and commercial xenograft, decellularized matrix induces the formation of the new bone tissue by day 60. Decellularized matrix can be considered as a biomaterial for cell-free tissue engineering for alveolar bone restoration in dentistry and maxillofacial surgery.

Osteogenic Potential of Decellularized Tooth Matrix.

We studied the possibility of using decellularized tooth matrix as a scaffold to restore bone tissue. It was found that mesenchymal stem cells underwent spontaneous osteogenic differentiation on the decellularized tooth matrix, which makes it possible to use it as a natural allograft in the treatment of resorption of alveolar bone tissue.

Peculiarities of Osteogenesis by Periosteal Cells after Experimental Ectopic Transplantation.

We carried out a comparative study of the features of osteogenesis from the progenitor osteogenic periosteal cells in rabbit and human. At the initial stages, high osteogenic potential of both human and rabbit periosteal cells was observed. However, at the later stages, the cell response favors resorption of the new bone tissue formed from periosteal cells in rabbits, but does not affect the bone tissue formed from human progenitor osteogenic periosteal cells. These functional characteristics of rabbit periosteal cells should be considered when planning the experiment.

[Peculiarities of the action of hyaluronidase of different origin to the connective tissue].

The lecture is devoted to consideration of mechanism of therapeutic action of the enzyme hyaluronidase in hyperplastic connective tissue. Drugs based on hyaluronidase increase bioavailability of other drugs used in adjuvant therapy; they significantly increase effectiveness of treatment, and also provide targeted synthesis of hyaluronic acid, ths regulating the regeneration process of connective tissue.

[Tumor stem cells in breast cancer].

High mortality from breast cancer is associated with the high heterogeneity of tumor and the frequent recurrences of the pathological process, which are due to the presence of tumor stem cells. The review considers the biological properties of tumor stem cells, the molecular mechanisms of their regulation, interaction with the microenvironment, and their role in the heterogeneity of the morphological and clinical forms of breast cancer.

[Clinical and urodynamic evaluation of efficacy of conservative treatment of urination disorders in patients with benign prostate hyperplasia].

17 patients (mean age, 61 +/- 1.7 years) with an benign prostate hyperplasia (BPH) and urination disorders were under observation. After examination by ultrasound, urodynamic and laboratory studies, patients received conservative combined therapy, including alpha1-adrenoblocker silodosin, L-carnitine, B vitamins and picamilon. As a result of the 4,5-month treatment, most of the symptoms were eliminated as evidenced by the decrease in IPSS score from 17 to 3; urodynamic parameters have improved that was recorded by the home uroflowmetry. It was concluded that the use of proposed combined therapy in patients with BPH as the first stage of treatment, followed by the administration of 5alpha-reductase inhibitors or performing surgical correction in case of formation of bladder outlet obstruction is justified.

[Clinical and urodynamic rationale of the overactive bladder neurophysiological model].

The analysis of 58 cases of overactive bladder has shown that detrusor activity is not linked with clinical symptoms but is caused by supra segmentary lesion of the nervous system. The clinical picture of overactive bladder fits the proposed neurophysiological model where ischemic damage of the association neuron located in the lumbar spinal marrow triggers miction disorders leading to preganglionary detrusor denervation. Combined therapy with alpha1-adrenoblocker and M-cholinolytic is pathogenetically sound. Trospium chloride (spasmex) was used for long-term treatment of the patients as it produces minimal number of side effects and enables dose and schedule variation.

[Pharmacourodynamic non-invasive studies in patients with prostatic adenoma].

After examination 47 patients with prostatic adenoma (mean age 63 years) received a course of alpha1-adenoblocker (omsulosin in a dose 0.4 mg/day). A three-day uroflowmetric monitoring was made at home before and after treatment. The findings were assessed with Liverpool nomo-gram by maximal flow. Omsulosin treatment was found to change voiding structure, to identify the obstructive component due to displacement of the flow characteristics to the low centiles of the nomogram. Thus, long-term treatment with alpha1-adrenoblockers can be used as a pharmacourodynamic test to detect infravesical obstruction in patients with prostatic adenoma.

[Sexual dysfunction in women with overactive bladder and their correction with m-cholinolytic spasmex].

A 4-month course of spasmex (15 mg three times a day) was conducted in 57 females (age 18-69 years, mean age 48 years) suffering from imperative urination manifesting as pollakiuria, imperative urges and urgent urinary incontinence in combination with sexual disorders. After the treatment the score of urination disorders went down from 21.4 to 12.7. Quality of life score decreased from 4.3 to 1.7. Sexual dysfunction diminished from 3.6 to 0.8 points. Clinical data showed that spasmex has a marked effect on m-cholinoreceptors, is well tolerated, has a moderate spasmolytic effect on the smooth muscles of the lower urinary tract. Moreover, spasmex can be used for correction of female sexual dysfunction caused by overactive bladder.

[24-h dynamics of urination in patients with overactive urinary bladder].

Home 3-day uroflowmetry was made in 41 female patients (mean age 46 years) before and after therapy for overactive bladder (OB). The course of therapy lasting from 6 weeks to 3 months included M-cholinolytics and vascular medication. Estimation of the bladder capacity in different time of 24-h period revealed circadian deviations of urinary flow and volumes. Administration of short-term M-cholinolytics enables chronotherapy providing maximal effects within 4-6 hours, possibility to vary doses. In view of this, optimal cholinergic therapy of OB is trospium chloride which has necessary properties, high safety and wide dose range.

[Changes in lower urinary tract function in children with hyperactive urinary bladder treated with combined therapy].

Low clinical efficacy of M-cholinolytics remains a serious problem in conservative therapy of hyperactive bladder (HB). To improve treatment outcomes, combined therapy (pikamilon plus driptan) was tried in 22 boys and 25 girls aged 7 to 14 years. The children were examined with uroflowmetry, cystometry. The response to the treatment was found to depend on mean effective capacity of the urinary bladder. Duration ofurodynamic correction has a negative colleration with this capacity. Urodynamic investigations performed in different periods of therapy show that improvement of lower urinary tract function is pathogenetically important for treatment of children with urologic pathology running in the presence of hyperactive urinary bladder.

[M-cholinolytic spasmex and its role in preoperative preparation of patients with urine incontinence].

Non-invasive uroflowmetric monitoring in females with combined incontinence has demonstrated that hyperactive urinary bladder and stress urine incontinence in females are similar in relation to functional disorders of the low urinary tract both in complete and partial syndrome of imperative urination. In the latter case, when imperative urine incontinence is absent, voiding structure is changed in the same manner, and the patients' preparation for surgical intervention demands long-term treatment with M-cholinolytics. We propose to use spasmex (trospium chloride) which has minimal side effects in long-term therapy. Conservative therapy of such patients with spasmex radically changes background for planning surgical intervention.

[Substantiation of the duration of m-cholinolytics administration in conservative treatment of hyperactive urinary bladder].

The analysis of treatment outcomes in 74 patients with hyperactive urinary bladder (HUB) has shown that duration of the treatment depends on the initial function of the lower urinary tracts. There was a correlation between mean effective therapy and treatment duration. Estimation of this correlation allows prognosis of treatment efficacy and selection of optimal anticholinergic drug for correction of miction disorders. Spasmex proved to be the most adequate drug for long-term treatment due to minimal number of side effects and feasibility to vary dose and regimen of intake.

[The role of alpha1-adrenoblocker alfuzosine in diagnostic-therapeutic algorithm of hyperactive urinary bladder management in women and selection of patients for treatment with M-cholinergic antagonists].

In management of patients with hyperactive urinary bladder (HAUB) it is necessary to take into consideration the fact that long-term intake of M-cholinergic antagonists may result in obstructive miction because of low contractile activity of the urinary bladder. Use of M-cholinergic antagonists also problematic in detruzor dysfunction leading to slowing down of the urinary flow. In view of these possible complications, an algorithm of urodynamic diagnosis is proposed based on non-invasive registration of miction disorders using home uroflowmetry. Correction of detruzor contractility with dalfas combines well with cholinoblockers. In some cases administration of nontitrated alphablockers has no alternative especially in long-term treatment with mediators suppressing nonadapted detruzor contractions as it happens in HAUB. The above diagnosticotherapeutic algorithm of female miction disorders management which regards urine flow rates and comprises intake of alfusozine if necessary allows treatment of females with small urinary bladder when cholinergic antagonists are low-effective.

[Role of a transforming growth factor beta-1 in regulation of invasive growth of prostatic adenocarcinoma]. / Rol' transformiruiushchego faktora rosta beta 1 v reguliatsii invazivnogo rosta adenocartsinomy predstal'noi zhelezy.

Immunohistochemical study of histological sections and immunochemical study in supernatants of primary cultures demonstrated a marked increase of the factor production in the regions of the background changes outside foci of carcinoma invasive growth. There was no difference in the type of expression of TGFbeta-I and TGFbeta-II receptors in morphologically different regions of the tumour. TGFbeta-I is considered as a principal factor that mediates hyperplastic reaction of the stroma in prostatic adenocarcinoma outside the zones of invasive growth. Formation of reactive stroma, in the authors' opinion, plays the role of a defensive mechanism hindering invasion of tumour cells into the connective tissue and its progression.

[Combined treatment of voiding disorders in women with m-cholinolytic and alpha 1-adrenoblocker]. / Kombinirovannoe lechenie rasstroistv mocheispuskaniia u zhenshchin m-kholinolitikom v sochetanii s al'fa1-adrenoblokatorom.

The drug spasmex (trospium chloride) having an m-cholinolytic and myotropic spasmolytic action has been used for treatment of enuresis in women with imperative voiding syndrome. Spasmex was given in combination with alpha 1-adrenoblockers to 20 women. The clinical picture was assessed with the original table. Urodynamic alterations were registered by means of home uroflowmeter. Clinical parameters improved 2 times after 4 weeks of the treatment. Mean effective capacity of the urinary bladder increased by 25%. Spasmex in combination with terasozine was well tolerated and had no side effects.

[Role of urodynamics correction in combined therapy of children with urinary infection]. / Znachenie korrektsii urodinamiki v kompleksnoi terapii detei s infektsiei mochevyvodiashchikh putei.

The authors propose differentiated complexes of therapy of children with urinary infection. These complexes include medicines (M-cholinolytics, antihypoxic drugs and drugs improving microcirculation) and low-invasive therapy. Clinical experience is reported for 4 boys and 40 girls with microbial-inflammatory urinary diseases. Standard urodynamic tests were made in all the patients before and after the course of therapy. Three variants of driptan effects on the urinary bladder were identified: M-cholinolytic, spasmolytic and mixed (larger volume and lower intravesical hypertension). Some of the patients experienced standard endoscopic reflux correction with the use of synthetic hydrophilic gel. Control urodynamic examinations 3 months after the treatment showed that functional disorders were reduced. Treatment efficacy was assessed with home flowmetry. Thus, combined therapy of microbial-inflammatory diseases with parallel correction of lower urinary tracts urodynamics by M-cholinolytics improves treatment results. Courses of antibacterial and uroceptic therapy should be followed by non-invasive monitoring to reveal urodynamic disorders, define dysfunction type and perform an additional treatment with mediators in combination with physiotherapeutic procedures.

[Primary culture of prostatic adenocarcinoma: a model for studies of stromal-epithelial interactions]. / Pervichnaia kul'tura adenokartsinomy prostaty: model' dlia izucheniia stromal'no-épitelial'nykh vzaimodeistvii.

Primary culture of prostatic adenocarcinoma is obtained from surgical material after radical prostatectomy. Typing of the obtained culture with antibodies to vimentin and cytokeratins has shown that the proportion of basic cell components--stromal and epithelial--in vitro correlates with such in the initial tumor tissue. In cultivation in different media active migration and proliferation of all cell types in the presence of embryonal serum and suppression of the stromal component in the medium where the serum was replaced for bovine hypophysis extract were observed. A comparative immunohistochemical analysis registered a release into culture of alpha SMA-positive myofibroblasts and active expression of TGF beta-1 in the medium containing serum. Design of dynamic mixed cell systems may serve a convenient model for investigation of stromal-epithelial interactions and their changes in cancer progression.

[Prospects for differentiated conservative treatment of patients with benign prostatic hyperplasia]. / Perspektivy differentsirovannoi konservativnoi terapii bol'nykh s dobrokachestvennoi giperplaziei predstatel'noi zhelezy.

The results of conservative therapy of 30 patients aged from 50 to 79 years with benign hyperplasia of prostate according to the IPSS scale from 7 to 30 points were analyzed. Under the influence of treatment in all the patients the clinical symptoms severity, according to the monitoring data using the IPSS tables, had reduced by 72% at average and quality of life improve no less than by 50%. Average efficacy of the volume and volumetric of urination had enhanced according to uroflowmetry data.

Antibody to hepatitis E virus in HIV-infected individuals and AIDS patients.

Antibody to hepatitis E virus of IgG class (anti-HEV IgG) is regularly detected in industrialized countries, where HEV is non-endemic, at levels not exceeding 2-3%; seropositive individuals are often found in certain groups of patients and professionals exposed to an increased risk of blood-borne infections. The present study was aimed at the identification of anti-HEV IgG in patients with human immunodeficiency virus (HIV) infection, including acquired immune deficiency syndrome (AIDS), living in Russia and Belarus, an area of low anti-HEV prevalence with a moderate spread of HIV infection and AIDS. In Russia, 13 out of 117 HIV-infected patients (11.1%) were found to be anti-HEV seropositive. This differed significantly from the frequency observed in the normal population (1.7%) but not from the frequency in a matching control, high-risk group consisting of male prisoners (8.0%). No difference in the frequency of anti-HEV IgG seropositivity was found between groups of HIV-infected men subdivided by sexual orientation. The rate of anti-HEV seropositivity increased with the progression of HIV infection, reaching 43.3% in AIDS patients and 38.1% in those who died from AIDS. In Belarus, anti-HEV IgG seropositivity was not found among 20 HIV-infected subjects nor among individuals from the control risk group, which consisted of 25 intravenous drug users. In conclusion, HEV infection may have common transmission mechanisms (risk factors) with HIV infection rather than represent an additional opportunistic infection in AIDS.