[Features of neurohumoral regulation in children with combined dysfunction of the pelvic organs].

During examination of 165 children aged 5 to 15 years (primarily identified during planned monitoring in Petrozavodsk children's institutions) with dysfunctional urination and encopresis without organic lesion of the central nervous system, autonomic dysfunction syndrome (ADS) was revealed. According to the results of urological examination, which was supplemented with the registration of spontaneous voiding rate and counting the radial pulse, overactive bladder syndrome and insufficient relaxation of the pelvic floor muscles during urination and defecation were detected; relationship between the number of heart rate (as a marker of sympathetic nervous system activity) and the effective volume was identified. It was revealed that the children with ADS in the presence of tachycardia show intermittent decrease of effective amounts of urination, and have residual urine. The standard course of treatment using colon hydrotherapy and biofeedback to activate cystic and obturator reflex caused a positive but short-term therapeutic effect; clinically and statistically significant increase in the effective volume of the bladder was not achieved, despite the reduction in residual urine volume. During the course of treatment using methods of biofeedback, bladder volume remained almost unchanged and tachycardia persisted, indicating the continued oppression of the sympathetic activity. The course of treatment using nootropic drug picamilon and alpha-adrenoblocker doxazosin with peripheral actions allowed to restore the reservoir and evacuation functions of the bladder, to achieve a regular bowel movement without encopresis. It was revealed that the combined dysfunction of pelvic organs occur in children with high activity of the sympathetic division of the ANS, which has a direct impact on the accumulation phase of voiding cycle and relaxation of the pelvic floor muscles.

[Viagra effects on polysystemic energy metabolism in stress (an experimental study)]. / Vliianie viagry na sostoianie polisistemnogo énergeticheskogo metabolizma pri stresse (éksperimental'noe issledovanie).

Experiments on 40 white rats were made to study effects of cardura (doxasozine) and viagra on polysystemic energy metabolism in stress. All the animals were examined for cytochemical activity of succinate dehydrogenase, lactate dehydrogenase in blood lymphocytes, antioxidant activity of blood plasm, levels of hydroperoxides, malonic dialdehyde. 3-hour immobilization raises functional activity of mitochondria manifesting with intensification of energy metabolism. Adrenoreceptors blockade by cardura prevents changes in the cellular metabolism. The same antistress effect is observed in viagra action. This newly discovered mechanism may prevent complications of adrenergic reactions accompanying sexual intercourse.

Parameters of cell energy metabolism during stress in laboratory animals and energotropic effect of alpha1-adrenoblocker doxazosin.

Cytochemical activity of succinate dehydrogenase and lactate dehydrogenase in blood lymphocytes, activity of hydroperoxides, MDA, and blood plasma antioxidants were studied in experimental animals during immobilization stress after preliminary injection of doxazosin. Preliminary adrenergic receptor blockade prevented changes in cell metabolism characteristic of immobilization stress. The role of adrenergic regulation in the realization of energotropic effects during immobilization stress was examined.

[Validation of the treatment of the neurogenic bladder in children with myelodysplasia using pikamilon]. / Obosnovanie lecheniia neirogennogo mochevogo puzyria u detei s mielodisplaziei pikamilonom.

An original Russian drug pikamilone with central (vegetotropic, vascular) and peripheral (vasodilation) mechanism of action and m-cholinolytic atropine were investigated for effect on detrusor function in the accumulation phase in 26 children with neurogenic bladder due to myelodysplasia. The detrusor function was assessed at retrograde cystometry performed before and after the drugs administration. The cystotonograms were estimated using a computer program of Relief urosystem according to the standard and additional indices. Pikamilone was found to potentiate the effects of atropine. This may be due to improvement of circulation and reduction of detrusor hypoxia. It is stated that selective chemotherapy of neurogenic bladder is uneffective. The preference should be given to combination of the drugs affecting main components of its dysfunction pathogenesis. Pikamilone should be referred to basic drugs for treatment of neurogenic bladder in spinal patients as its combination with atropine possesses a unique efficacy in restoration of the reservoir function of the bladder.

[A computer program for the support of the treatment-diagnosis process for patients with benign prostatic hyperplasia]. / Komp'iuternaia programma podderzhki lechebno-diagnosticheskogo protsessa u bol'nykh s dobrokachestvennoi giperplaziei predstatel'noi zhelezy.

The computer program "Prostate" (Windows, 1.0 version) is designed to assist the urologist in: objective assessment of the lower urinary tract in benign prostatic hyperplasia (BPH), accumulation and storage of information on the patients (data file), comparison (text, graphics) with previous data to control the course of the disease, treatment efficacy, to refer to international recommendations and recent advances in the treatment of both BPH and its complications. The status of the lower urinary tract is to be described basing on the IPSS and QOL tables, PSA findings, rhythm of spontaneous uresis, uroflowmetry, residual urine, prostate size, laboratory and microbiological urinalysis. The program "Prostate" is a new step in medical recording and efficacy of BPH treatment assessment in urology.

[The role of detrusor hypoxia in the pathogenesis of urination disorders in patients with benign prostatic hyperplasia]. / Rol' gipoksii detruzora v patogeneze rasstroistv mocheispuskaniia u bol'nykh dobrokachestvennoi giperplaziei predstatel'noi zhelezy.

The aim of the study was to clarify the role of hypoxia of detrusor as a component of aging in establishment of urination disorders in patients with benign prostatic hyperplasia (BPH). A total of 54 patients were examined. Whether the capacity of detrusor to absorb oxygen was affected or not was judged by the difference in oxygen tension and acid-base balance in blood samples obtained intraoperatively from a radialis, v. mediana cubiti, v. vesicalis in 30 patients (experimental group) versus control values (5 females operated for stenosis of the distal ureter, ureterovaginal fistulas). The findings provided evidence for marked hypoxia of the detrusor diminishing reservoir function of the bladder and promoting urination disorders. A course of hyperbaric oxygenation given to 17 BPH patients has improved the capacity of the bladder for urine accumulation, reduced pollakiuria, especially at night. This supports involvement of detrusor hypoxia in pathogenesis of urination disorders in BPH patients.

[Electrophysiologic diagnosis of neurogenic bladder in children with myelodysplasia]. / Elektrofiziologicheskaia diagnostika neirogennogo mochevogo puzyria u detei c mielodisplaziei.

Ninety-seven children with neurogenic bladder and myelodysplasia were subjected to complex examination. The somatic innervation of the sphincter urethrae externus and sphincter ani muscles was appraised by the method of sacral guided reactions by a CT-01 electromyograph and by an original method consisting in registration of the reflex response of the named anatomical structures according to the fluctuations of the intraurethral and intraanal pressure. It was established that maintained, partly disturbed, and absolutely absent somatic innervation of the sphincters of the bladder and rectum is encountered in patients with myelodysplasia. The more the innervation of the sphincters disturbed is, the more the urinary bladder is excluded from the "accumulation-evacuation" urodynamic cycle and the lesser the probability of disorders of urodynamics of the upper urinary tract is, and vice versa. The obtained information is important in choosing the therapeutic tactics for patients with a neurogenic bladder.

[The role of estrogens in the pathogenesis of bladder dysfunction of the hyperreflexia type and vesico-ureteral reflux in children]. / Rol' éstrogenov v patogeneze neirogennoi disfunktsii mochevogo puzyria giperreflektornogo tipa i puzyrno-mochetochnikovogo refliuksa u detei.

Patients with the uninhibited urinary bladder of the hyperreflexia type and the vesicoureteral reflux were subjected to multimodality examinations which included excretory urography, retrograde cystometry, cystography, profilometry of the ureterovesical anastomosis, cytologic investigation of estrogenic saturation, determination of the concentration of follicle-stimulating hormone of the pituitary and estradiol by means of radioimmunoassay. As many as 56 girls aged 4 to 15 years underwent examination. It has been demonstrated that dysfunction of the urinary bladder of the hyperreflexia type is of crucial role as an active mechanism of extra-vesicalization of the intra-vesical part of the ureter, associated with its antireflux function distress.

[Effect of antibiotics on D-serotonin-reactive structures]. / Vliianie nekotorykh antibiotikov na D-serotoninoreaktivnye struktury.

Experiments on the isolated organs showed that ampicillin and levomycetin have pronounced D-antiserotoninergic effects; antagonism of antibodies and serotonin was found to be of competitive type. At an increase in levomycetin dosage D-antiserotoninergic effect was followed by the spasmolytic effect. Kefzol and benzylpenicillin failed to show any D-antiserotonin-ergic properties.