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To study the prevalence of functional phimosis determined during erection in patients over 18 years of age, as well as the features of its diagnosis and treatment in outpatient practice.A retrospective study that included 201 patients who underwent circumcision at a mean age of 42.7 years, was carried out. Complaints, history, initial examination and autophotography of the penis during erection were evaluated. The subjects were divided into 2 groups. The group I (n=38) included patients complaining of the inability to reveal the glans penis during erection, while in group II (n=163) men with similar complaints in a f laccid state of the penis were included. All patients underwent circumcision under local anesthesia.The proportion of functional phimosis was 18.9%. The mean age in groups I and II was significantly different (29.47+/-8.82 and 45.6+/-19.4 years, respectively, p0.01). In 14 (36.8%) patients of group I, a short frenulum was also diagnosed. Primary phimosis was detected in 26.3% and 14.1% of patients in groups I and II (p0.05), respectively. The acquired phimosis was diagnosed in 73.7% and 85.9% (p0.05) of cases, respectively. There were no concomitant diseases in patients with "functional" phimosis, while in men with "pathological" phimosis, 22.7% of patients had various comorbidities, such as diabetes mellitus, coronary heart disease, hypertension, etc. CONCLUSIONS: Among patients who visit a urologist with a diagnosis of phimosis, almost every fifth man has functional form (18.9%). For the diagnosis of the phimosis, the history taking and autophotography of the penis during erection have an important role. In this category of patients, surgical treatment can be performed on an outpatient basis.

Severe Acute Respiratory Syndrome (SARS-CoV-2) has spread rapidly throughout the world, causing high morbidity and mortality Analysis of clinical and autopsy data may allow to understand this disease The results of pulmonary and renal autopsies in 37 deceased patients from COVID-19 are presented Materials and methods An autopsy was performed in Moscow in 37 deceased patients aged from 28 to 94 years The microscopic features of the lungs and kidneys were examined using hematoxylin and eosin staining Results Important findings include diffuse alveolar injury, pulmonary thrombosis and microangiopathy, as well as acute kidney injury in all cases, varying in severity Conclusions We report the presence of acute kidney injury in all cases, which requires correction of renal function in patients with SARS-CoV-2, with control of serum creatinine levels, urine volume, proteinuria and hematuria Тяжелый острый респираторный синдром (SARS-CoV-2) быстро распространился по всему миру, вызвав высокую заболеваемость и смертность Анализ клинических данных и данных аутопсии может помочь нам разобраться в данной болезни Мы представляем результаты легочной и почечной аутопсии у 37 умерших от COVID-19 пациентов Материалы и методы В Москве произведена аутопсия 37 умершим пациентам в возрасте от 28 до 94 лет Были исследованы микроскопические особенности легких и почек с помощью окрашивания гематоксилином и эозином Результаты Важные результаты включают диффузное альвеолярное повреждение, тромбоз и микроангиопатию в легких, а также острое повреждение почек во всех случаях различной степени тяжести Выводы Мы сообщаем о наличии острого повреждения почек во всех исследуемых случаях, что требует коррекции функции почек у больных SARS-CоV-2 с контролем уровня креатинина в плазме крови, объема мочи, наличия протеинурии и гематурии

During the spread of bacterial infections with extensive drug resistance, the potential of existing antibacterial drugs is significantly reduced. The medical community is seeking opportunities for the rational use of antibacterial drugs, the development of new drugs, as well as the use of alternative treatments for these infections. Aim. The objective of this study was to evaluate the effectiveness of the use of a complex antibacterial and analgesic drug based on bacteriophages in gel form during various instrumental studies and diagnostic procedures in order to minimize the risk of the urinary system infections complications. Materials and methods. The study included 235 women aged 18 to 75 years who underwent treatment at the Moscow State Clinical Hospital named after Spasokukotsky and in the clinic of urology of Moscow State University of Medicine and Dentistry from September 2019 to January 2020. During the manipulation, all patients of the main group (n=120) used a developed preparation based on bacteriophages, and in the control group (n=115), a topical gel based on chlorhexidine dihydrochloride and lidocaine hydrochloride was used. All patients before the manipulation, as well as 10 days after the manipulation, underwent bacteriological analysis of urine. Efficiency assessment was carried out on the basis of laboratory data obtained, as well as according to the visual analogue scale of the pain syndrome severity. Results. None of the patients in the main group showed intolerance, side effects and allergic reactions of the developed drug based on bacteriophages. Bacteriological analysis of urine received before manipulation in both groups showed the absence of clinically significant titers of pathogenic bacteria, while 1 week after manipulation the number of titers of pathogenic bacteria (104) was significantly higher in the control group (p0.04). In patients of the main group, the incidence of dysuria was lower compared with the control group (p0.05). Conclusion. The study showed good tolerance of the developed drug and its clinical effectiveness in reducing the number of symptomatic bacteriuria; severity of pain after undergoing manipulation was relatively lower in the main group of patients. Conducting multicenter studies with the inclusion of a larger number of patients in the future will reduce the economic costs associated with treating patients by reducing the number of cases of nosocomial infections and reducing postoperative time spent by patients in the hospital.

In modern clinical practice, antimicrobial resistance creates a significant problem for the effective metaphylaxis of various infectious and inflammatory diseases of the urinary system. Annually, researchers note an increasing number of mutations in the genomes of bacteria that cause infectious diseases, which leads to the appearance of more aggressive strains. The inefficiency of antibiotic therapy requires to a search for alternative methods for treatment and prevention of infectious diseases. use of viruses that infect bacteria (bacteriophages) represent one of such methods. A literature review of recent publications indicates that phage therapy has been gained significant increase. The general aspects of phage therapy, mechanism of action, as well as the existing possibilities and limitations of phage therapy in treatment and prevention of infectious diseases of the urinary system are highlighted in this article.

Severe Acute Respiratory Syndrome (SARS-CoV-2) has spread rapidly throughout the world, causing high morbidity and mortality. Analysis of clinical and autopsy data may allow to understand this disease. The results of pulmonary and renal autopsies in 37 deceased patients from COVID-19 are presented.An autopsy was performed in Moscow in 37 deceased patients aged from 28 to 94 years. The microscopic features of the lungs and kidneys were examined using hematoxylin and eosin staining.Important findings include diffuse alveolar injury, pulmonary thrombosis and microangiopathy, as well as acute kidney injury in all cases, varying in severity.We report the presence of acute kidney injury in all cases, which requires correction of renal function in patients with SARS-CoV-2, with control of serum creatinine levels, urine volume, proteinuria and hematuria.

Urinary tract infections are one of the most common and widespread infectious diseases. A certain role in etiopathogenesis may play genetic predisposition, as well as a decrease in antiadhesive properties and an increase in urothelium permeability due to incompetence of bladder glycosaminoglycan layer. The prevalence of infectious diseases increases significantly with age, as well as in patients with chronic diseases. The introduction of modern biotechnology has allowed clinicians to greatly expand therapeutic armamentarium, while having a number of advantages, including minimal frequency of complications and adverse events, the possibility for long-term use, accessibility, and etc. Priority research areas include the study of toll-like receptors, which are transmembrane proteins that provide pathogen recognition and activate the immune response. The role of these receptors in the development of the immune response to urinary tract infections was evaluated in our study, which allows to predict the course of the disease and to increase treatment efficiency.

В развитии рака предстательной железы (РПЖ) макрофаги играют важную роль. Многие опухоли выделяют противовоспалительные цитокины, которые перепрограммируют М1 фенотип макрофагов на проопухолевый М2 фенотип. М2 макрофаги подавляют противоопухолевый иммунитет, способствуют делению и метастазированию опухолевых клеток. Предыдущие исследования позволили нам обосновать предположение, что деление опухолевых клеток РПЖ человека может быть ограничено особым М3 фенотипом макрофагов. Фенотип М3, в отличие от М1 фенотипа, реагирует на противовоспалительные цитокины увеличением продукции провоспалительных противоопухолевых цитокинов, что способствует сохранению их противоопухолевых свойств в зоне опухоли. Цель исследования - проверка гипотезы о способности М3 макрофагов останавливать деление клеток предстательной железы больного РПЖ. Методика. В работе использовали макрофаги мышей, выделенные из перитонеального лаважа и макрофаги человека, полученные из моноцитов крови больных РПЖ. Фенотип М3 макрофагов получали добавлением в среду культивирования IFN-γ, ингибиторов STAT3, STAT6 и SMAD3 с последующей стимуляцией липополисахаридом. Результаты. Показано, что М3 макрофаги мышей и человека ограничивали деление клеток предстательной железы больных РПЖ в условиях 2D (на плоскости) культивирования на 43% и 93%, соответственно. При 3D (в объеме) культивировании М3 макрофаги мышей не ограничивали, а М3 макрофаги человека лишь незначительно ограничивали деление клеток предстательной железы у больных РПЖ. Заключение. Результаты работы делают обоснованными дальнейшие исследования и разработку клинической версии биотехнологии лечения рака предстательной железы с использованием М3 макрофагов.Macrophages play an important role in the development of prostate cancer (PCa). Many tumors, including PCa, secrete anti-inflammatory cytokines that reprogram the M1 macrophage phenotype into the pro-tumor M2 phenotype. M2 macrophages suppress antitumor immunity and promote division and metastasis of tumor cells. We hypothesized that the division of human PCa cells may be restricted by a specific M3 macrophage phenotype. The M3 phenotype, in contrast to the M1 phenotype, responds to anti-inflammatory cytokines by increasing the production of inflammatory anti-tumor cytokines and retains its anti-tumor properties in the tumor area. The aim of the study was to test the hypothesis on the ability of M3 macrophages to stop division of prostate cells from patients with PCa. Methods. This study used murine macrophages isolated from the peritoneal lavage and human macrophages obtained from blood monocytes of patients with PCa. The M3 macrophage phenotype was obtained by adding IFN-γ, STAT3, STAT6, and SMAD3 inhibitors to the cultural medium followed by lipopolysaccharide (LPS) stimulation. Results. Murine and human M3 macrophages restricted the division of patients’ PCa cells in the conditions of 2D cultivation by 43% and 93%, respectively. In 3D cultivation, murine M3 macrophages did not restrict whereas human M3 macrophages only slightly limited the division of prostate cells from PCa patients. The results of the study warrant further research and development of a clinical biotechnology for PCa treatment with reprogrammed M3 macrophages.

Introduction . Histological grading system is an important prognostic factor of bladder cancer. Grading of urothelial carcinoma has been a matter of debate since the three-grade system was introduced in 1973. Objective . Optimization of the grading system for urothelial carcinoma. Materials and methods . An analysis of literature devoted to evaluation of diagnostic significance, variability and interobserver reproducibility of the existing classifications of urothelial cancer of the bladder proposed in 1973, 1998, 1999 and 2004. Results . The classification proposed in 1973 is the most popular and time honored method of grading bladder tumors. In 1998 it was modified by the International Society of Urological Pathology. In 1999 the World Health Organization (WHO) approved a new classification which preserved the three-grade system but differed from the previous ones. According to this new classification, tumors could fall into the following categories: papilloma, papillary urothelial neoplasm of low malignant potential, urothelial carcinoma of I, II, and III malignancy grade. The definition of papilloma was identical in all of these classifications. In 2004 a new WHO classification was introduced in which non-invasive urothelial tumors were subdivided into papilloma, papillary urothelial neoplasm of low malignant potential and low and high grade carcinoma. All of the proposed grading systems had a certain level of subjectivity and interobserver reproducibility, but reproducibility between unfamiliar pathologists was considerably higher than in groups of pathologists who had studied or worked together. Importantly, the 2004 WHO classification aimed to provide a detailed explanation of histological criteria for each diagnostic category and therefore improve reproducibility between different pathologists. However, no improvement of reproducibility in comparison with the 1973 WHO classification was observed. Moreover, among the pathologists better reproducibility of the 1973 WHO classification was registered compared to the 1999 and 2004 classifications. Reproducibility of the papillary urothelial neoplasm of low malignant potential diagnosis was only 48 %. At the same time, reproducibility of the 1973 WHO classification too has its problems. The biggest criticism is ambiguity in the diagnostic criteria of the 3 grades of urothelial carcinoma. Conclusions. Standardization of the grading system of superficial bladder cancer allows to validate comparison between treatment outcomes in different centers. Introduction of the 2004 classification is the first step to treatment and monitoring standardization, but all of the classifications proposed by the WHO have shortcomings caused by considerable heterogeneity of papillary urothelial neoplasms. Significant interobserver reproducibility between papillary urothelial neoplasm of low malignant potential and low grade papillary urothelial carcinoma shows inadvisability of creating a separate diagnostic category for papillary urothelial neoplasm of low malignant potential.

There is a clear need in molecular markers of prostate cancer (PC) that would specify stratification of patients into risk categories and serve as additional parameters to clinical prognostic factors. Altered DNA methylation status is one of molecular processes that occur during PC development. The gene methylation status may be evaluated in laboratory diagnostics by a PCR approach known as means of methylation-sensitive high resolution melting (MS-HRM) curve analysis. This method is particularly promising due to minimal amounts of DNA required for analysis (10 ng). To date, numerous data based on the use of Infinium HumanMethylation450 BeadChip (HM450) technology have been accumulated on DNA methylation in PC samples. However, it remains unclear whether the MS-HRM results are consistent with chip hybridization data. The aim of this study was to perform the comparative analysis of the diagnostic informativeness of MS-HRM and HM450 chip hybridization methods in determination of the methylation status of three genes GSTP1, APC, and RASSF1 in samples obtained from PC patients. The study has shown that using the MS-HRM method it is possible to discriminate PC tumor samples from samples of histologically unaltered prostate tissue by analyzing the methylation status of each gene. Analysis of chip hybridization data confirmed the results obtained by MS-HRM. Differences between tumor tissue and histologically intact tissue obtained from each PC patient in the methylation levels of GSTP1, APC, and RASSF1, determined by MS-HRM or chip hybridization were consistent with each other. Thus, the assessment of the methylation level of gene GSTP1, APC, and RASSF1 using MS-HRM can become the basis for the development of a laboratory test, the specifying diagnosis of prostate cancer.

Introduction . To increase accuracy of disease prognosis in patients with bladder cancer we propose determination of expression level of several tumor markers. Objective is evaluation of prognostic significance of Ki-67 expression level in risk of non-muscle invasive bladder cancer recurrence. Materials and methods . To perform immunohistochemistry analysis of Ki-67 we used surgery material of 83 patients who underwent primary transurethral bladder resection due to non-muscle invasive cancer. We performed an analysis of correlation between Ki-67 expression level in malignant tissue removed by transurethral resection and characteristics of tumor development. We evaluated the role of Ki-67 in stratification of recurrence risk by comparing the level of Ki-67 antigen expression in patients with recurrent non-muscle invasive bladder cancer and in relapse-free patients. We present evaluation of sensitivity, specificity, and prognostic value of quantitative determination of Ki-67 expression level in relation to non-muscle invasive bladder cancer recurrence. Results . During the follow-up period, 41 cases of non-muscle invasive bladder tumor recurrence were observed. Quantitative value of the Ki-67 marker correlated with tumor differentiation grade G, malignancy grade, invasion into submucosal and muscle layers, presence of primary process, and tumor recurrence. In comparison with relapse-free patients, a significantly higher level of Ki-67 expression was observed in patients with cancer recurrence (р = 0.0035). We have determined a threshold quantitative value of Ki-67 (48 %) indicating disease recurrence. Presence of a threshold value of the Ki-67 marker showed moderate sensitivity level (less than 71 %) with relatively low specificity level (57 %). However prognostic level wasn’t high (between 63 and 65 %). Conclusion . In patients with recurrent non-muscle invasive bladder cancer an elevated level of Ki-67 expression was observed in comparison with relapse-free patients (test sensitivity was 70.7 %). Obviously, determination of molecular biomarkers, Ki-67 in particular, can potentially help distinguish highly malignant tumors with high progression and recurrence risk, which can significantly improve treatment results for these patients. However, this problem requires further research.

// Anastasia S. Nikitina 1, 2 , Elena I. Sharova 1 , Svetlana A. Danilenko 1 , Tatiana B. Butusova 1 , Alexandr O. Vasiliev 3 , Alexandr V. Govorov 3 , Elena A. Prilepskaya 3 , Dmitry Y. Pushkar 3 , Elena S. Kostryukova 1, 2 1 Federal Research and Clinical Center of Physical-Chemical Medicine, Moscow, Russia 2 Moscow Institute of Physics and Technology, Dolgoprudnyi, Russia 3 Department of Urology, Moscow State Medical Stomatological University, Moscow, Russia Correspondence to: Anastasia S. Nikitina, email: nikitina_as@niifhm.ru Keywords: prostate cancer, benign prostatic hyperplasia, RNA biomarkers, RNA-Seq, FFPE Received: November 01, 2016 Accepted: March 15, 2017 Published: March 23, 2017 ABSTRACT Due to heterogeneous multifocal nature of prostate cancer (PCa), there is currently a lack of biomarkers that stably distinguish it from benign prostatic hyperplasia (BPH), predict clinical outcome and guide the choice of optimal treatment. In this study RNA-seq analysis was applied to formalin-fixed paraffin-embedded (FFPE) tumor and matched normal tissue samples collected from Russian patients with PCa and BPH. We identified 3384 genes differentially expressed (DE) (FDR < 0.05) between tumor tissue of PCa patients and adjacent normal tissue as well as both tissue types from BPH patients. Overexpression of four of the discovered genes (ANKRD34B, NEK5, KCNG3, and PTPRT) was validated by RT-qPCR. Furthermore, the enrichment analysis of overrepresented microRNA and transcription factor (TF) recognition sites within DE genes revealed common regulatory elements of which 13 microRNAs and 53 TFs were thus linked to PCa for the first time. Moreover, 8 of these TFs (FOXJ2, GATA6, NFE2L1, NFIL3, PRRX2, TEF, EBF2 and ZBTB18) were found to be differentially expressed in this study making them not only candidate biomarkers of prostate cancer but also potential therapeutic targets.

Current prostate cancer (PCa) diagnostic tests suffer from insufficient sensitivity and specificity. Novel biomarkers that can be detected by minimally invasive methods are of a particular value. Here we provide two datasets. The first one is on the whole transcriptome profiling by RNA-seq of urine and plasma obtained from patients with PCa and benign prostatic hyperplasia (BPH). The second one represents targeted sequencing of DNA from urine and plasma of patients with PCa and BPH. Both datasets are available at NCBI Sequence Read Archive under Accession No. SRP093707 and No. SRP093842 respectively.

Prostate cancer (PCa) is the most frequently diagnosed among men malignant disease that remains poorly characterized at the molecular level. Advanced PCa is not curable, and the current treatment methods can only increase the life expectancy by several months. Identification of the genetic aberrations in tumor cells provides clues to understanding the mechanisms of PCa pathogenesis and the basis for developing new therapeutic approaches. Here we present data on somatic mutations, namely single nucleotide variations (SNVs), small insertions and deletions, detected in prostate tumor tissue obtained from Russian patients with PCa. Moreover, we provide a raw dataset on the whole exome and targeted DNA sequencing of tumor and non-tumor prostate tissue obtained from Russian patients with PCa and benign prostatic hyperplasia (BPH). This data is available at NCBI Sequence Read Archive under Accession No. PRJNA506922. Keywords: Prostate cancer, Somatic variants, Whole exome

The aim of this study is to improve the results of detection and treatment of patients with prostate cancer (PCa) in the Moscow. For this purpose, we performed our own clinical diagnostic, epidemiological, autopsy, experimental and comparative studies that emphasize the relevance of the stated subject in the study of the diagnosis and treatment of patients with PCa. Urology Department of A. I. Evdokimov Moscow State University of Medicine and Dentistry was at the forefront of the Men's Health program in Moscow and in early 2003 it was the first to have an office for early diagnosis of prostate diseases, as part of the Program. Over 20,000 patients were screened for PCa. For the first time in Russia, methods for the early detection of PCa were investigated on a cohort of Russian men using PCA3 and the Prostate Health Index. The role and significance of prostate saturation biopsy was examined. The investigation of aspects of the morphological assessment of prostate diseases formed the basis for the development of an electronic atlas of PCa images. A series of studies on various prostate visualization methods, including Histoscanning system and MRI, have been performed. A new minimally invasive method for the treatment of prostate cancer has been introduced - a robot-assisted radical prostatectomy and cryoablation. The concept of surgical treatment of localized forms of PCa has been developed and the factors predicting the success of treatment have been determined. This study is reflected in numerous publications both in Russia and abroad, in monographs and dissertations.

Purpose. Determination the role of the p53 expression as a prognostic factor in the development of superficial urothelial bladder carcinoma. Materials and methods. Medical histories of 72 patients (11 women and 61 men) with diagnosed primary superficial urothelial carcinoma of the bladder I and II grade were retrospectively analyzed. All patients were undergone a repeated transurethral resection was performed in 6 weeks after the first operation. In the case of the absence of residual tumor, cystoscopy was performed every 3 months during the first year then every 3–6 months during next 5 years. The average time of follow-up was 43.2 months. According to the standard protocol an immunohistochemical study with detection of p53 was carried out on 72 sections of formalin-fixed and paraffin-embedded tumor fragments. p53 expression was also determined in 10 histologically unchanged fragments of the bladder mucosa. Results. Depending on the percent of nuclei with p53 expression, two groups were identified. The first group included 40 tumor samples (55.5 %) with p53 expression less than 20 % and 17 tumor samples (23.6 %) without p53 expression. The second group included 15 tumor samples (20.9 %) with p53 expression more than 20 % (4 patients – 20–40 %, 8 patients – 40–60 %, 3 patients – 60–80 %). р53 expression was not determined in the all 10 samples of normal bladder tissue. During follow-up period 1 of 57 patients of the first group has a disease progression comparing with 13 of 15 patients in the second group. Patients of the both group were similar in respect with clinical characteristics. The mean time to disease progression was 17.3 months. Conclusion. Results of the current study shows that p53 immunohistochemical marker is a prognostic factor in the development of superficial urothelial bladder carcinoma.

Applicability of prostate cancer candidate RNA biomarkers screening in plasma and urine obtained by minimally invasive or noninvasive methods has been demonstrated. In patients with benign prostatic hyperplasia (BPH) significant amounts of RNAs known in the literature as biomarkers associated with prostate cancer have been detected in plasma and urine samples. Detectable amounts of the markers depended on the methods used for transcriptome profiling. Detection of known RNA biomarkers associated with prostate cancer in urine and plasma samples by the RNA-seq method shows its applicability for the search of new RNA biomarkers for minimally invasive diagnostics. However, the fact of the presence of known prostate cancer RNA biomarkers in samples from BPH patients suggests their insufficient specificity and indicates a clear need for further research in this field.

Using the technology of DNA chips Infinium HumanMethylation 450 BeadChip it was analyzed quantitative DNA methylation status in 12 paired samples of prostate adenocarcinoma, and morphologically altered tissues. Analysis of differentially methylated regions of the genome showed an association with abnormal status for 21610 and 3852 hypomethylated hyper-methylated CpG sites. Dominance in the cancer genome hypermethylated sites and their predominant localization in the regulatory regions of genes indicate their possible role in the implementation of mechanisms of gene suppression in the pathogenesis of prostate cancer (PCa). For 14 genes studied were characterized array maximum values hypermethylation in promoter region (50% CpG sites) in combination with a high level of methylation differences between treatment groups (40%). Role of hypermethylation in some of them: AOX1, KLF8, ZNF154, TMEM106A in the pathogenesis of prostate cancer has been showed previously. Hypermethylation of genes ACSS3, TAC1, TUBA4B, ZSCAN12 not previously been shown for prostate cancer, but is characterized by the association with other cancers. In turn, the differences in the levels of methylation in genes GPRASP1, NKX2-6, ARX, CYBA, EPSTI1, RHCG been documented as a result of a number of genome-research oncology, but has not been studied in detail. To assess the diagnostic potential of epigenetic markers of prostate cancer there was carried out unbiased selection of individual CpG sites most reliably discriminate against tumor samples from a group of no tumor samples. In selected diagnostic model based on logistic regression included 9 CpG sites. Validation of the model was carried out on an independent dataset of methylation of 40 paired samples from the prostate cancer project Atlas of Cancer Genome (TCGA) analyzed on the same version of the DNA chip. Summarized rates of diagnostic informativeness of a model (specificity 95%, sensitivity of 97%, the area under the curve of the diagnostic test (ROC) - 0,96), obtained after validation, allow us to consider these CpG Sites as potential markers for molecular diagnosis of prostate cancer.

Since the first use of robotic surgical system in 2000, the robot-assisted technology has gained wide popularity throughout the world. Robot-assisted surgical training is a complex issue that requires significant efforts from students and teacher. During the last two decades, simulation-based training had received active development due to wide-spread occurrence and popularization of laparoscopic and robot-assisted surgical techniques. We performed a systematic review to identify the currently available simulators for robot-assisted surgery. We searched the Medline and Pubmed, English sources of literature data, using the following key words and phrases: "robotics", "robotic surgery", "computer assisted surgery", "simulation", "computer simulation", "virtual reality", "surgical training", and "surgical education". There were identified 565 publications, which meet the key words and phrases; 19 publications were selected for the final analysis. It was established that simulation-based training is the most promising teaching tool that can be used in the training of the next generation robotic surgeons. Today the use of simulators to train surgeons is validated. Price of devices is an obvious barrier for inclusion in the program for training of robotic surgeons, but the lack of this tool will result in a sharp increase in the duration of specialists training.

Increasing prostate cancer incidence rates highlight the importance of more timely diagnosis with the ultimate aim of reducing cancer-specific mortality, while maintaining patients quality of life. Until recently, digital rectal examination and prostate-specific antigen have been used for diagnosis of prostate cancer. Recent advances in medical technologies and laboratory testing have led to introducing new cancer markers into clinical practice. The most highly demanded of them are the PCA-3, -2proPSA and Prostate Health Index. Despite the wide range of laboratory tests, a prostate biopsy with a subsequent morphological examination of biopsy tissue specimens remains the only way to definitively diagnose prostate cancer.

In case of recurrence of prostate cancer after radiation therapy patient may be offered salvage radical prostatectomy (both open and laparoscopic/robotic), hormone therapy, and a number of alternative techniques such as salvage cryoablation, HIFU-therapy and brachytherapy. Results of monitoring of patients for 10 years after salvage treatment of prostate cancer are known only after salvage prostatectomy. Technically radical prostatectomy after radiation therapy is associated with a large number of complications if compared with primary radical prostatectomy. The most frequent complications after salvage prostatectomy include incontinence, stricture formation of urethrovesical anastomosis, rectal injury, acute urinary retention and infectious complications.

Objective: to study orgasmic function (OF) in patients undergoing radical prostatectomy (RPE).Subjects and methods. Seventy-nine patients who had undergone RPE for locally advanced prostate cancer without hormone and radiation therapies were examined. The patients’ mean age was 59.3 years. The mean EF-IIEF domain score was 24.4. OF was estimated by IIEF question 10 and the authors’ questionnaire. The Spearman rank correction coefficient and Mann-Whitney U-Wilcoxon tests were used.Results. After RPE, there was a reduction in the mean IIEF question 10 score from 3.9 (confidence interval 3.7–4.1) to 3.3 (3–3.5) (p = 0.000). The following changes were found in orgasm intensity: no changes in 43 %, mild worsening in 42 %, severe worsening in 8 %, and enhancement in 4 %; orgasm could not be achieved in 4 % of the patients. Pain usually of low intensity was reported by 8.8 %. The poor factors for preserving OF were its low baseline level, elderly age, or severe post-RPE erectile dysfunction.Conclusion. There were significant OF changes after RPE, which should be kept in mind while treating this category of patients.

Background. Prostate cancer (PC) is one of the most common malignant tumors in men. The total Gleason (Gleason index) scores are one of the most important prognostic factors in patients with PC. The expression of p53 and Ki-67 proteins is also considered as a prognostic factor.Objective: to estimate the frequency with which the expression of these proteins shows up and to compare the findings with Gleason scores.Materials and methods. This investigation studied prostatic drugs after radical prostatectomy. The Gleason scale was use to rate the grade of a tumor. The expression of Ki-67 and p53 was an immunohistochemical method. The data were statistically processed using Spearman’s cor-relation test.Results. Based on the Gleason index, all the tumors were divided into 3 groups: 1) low grade (4–6 scores); 2) intermediate grade (7 scores); 3) high grade (8–10 scores). Group 1 included 5 (16 %) patients; Group 2 and 3 consisted of 19 (64 %) and 6 (20 %) patients, respectively. The expression of p53 and Ki-67 was observed in none of the low-grade tumor samples. There was a statistically significant relationship between higher Ki-67 proliferation and higher Gleason scores.Conclusion. In accordance with the results of this investigation, the expression of the marker Ki-67 can be used as a prognostic factor in PC. At the same time, a possible relationship between p53 expression and prognosis in PC calls for further investigation.

Background. Many investigators point out the importance of detecting the neuroendocrine differentiation of prostate adenocarcinoma (PA) and consider its relationship to the clinical picture of the disease and total Gleason scores (Gleason index).Objective: to study relations between the presence of markers indicative of neuroendocrine differentiation in PA tissue, Gleason index, and disease characteristics.Materials and methods. The fragments of the postoperative histological specimens obtained from 30 patients after radical prostatectomy in 2008 were stained by an immunohistochemical assay to identify specific markers of neuroendocrine differentiation: chromogranin A (CgA) and synaptophysin. The expression of the markers of neuroendocrine differentiation was compared to the clinical stage of the disease and Gleason index that was used to allocate the patients to 3 groups: low-, moderate-, and high-grade tumors.Results. The patients» mean age was 67 ± 9.2 years. Groups 1, 2, and 3 included 5, 19, and 6 patients, respectively. The expression of CgA was found in 10 % of Group 1 patients, in 33 % in Group 2, and in 40% in Group 3. CgA expression considerably increased with a higher Gleason score (p = 0.024).Conclusion. The expression of CgA is more than that of other used markers and correlates with the clinically determined stage of the disease. The expression of CgA increases with a higher grade, which can be potentially used to predict the course of the disease. The limitations of this investigation are associated with its retrospective pattern and a small sample size. The findings need to be clarified in a large cohort study.

The article is devoted to the development of the decision support system in urologic cancer diagnosis with the use of intelligent technology. The main stages of the system development are shown. The structure of medical decision support system is proposed. This system is designed to improve the accuracy of diagnosis.

There is a clear need in molecular markers for prostate cancer (PC) risk stratification. Alteration of DNA methylation is one of processes that occur during ÐÑ progression. Methylation-sensitive PCR with high resolution melting curve analysis (MS-HRM) can be used for gene methylation analysis in routine laboratory practice. This method requires very small amounts of DNA for analysis. Numerous results have been accumulated on DNA methylation in PC samples analyzed by the Infinium HumanMethylation450 BeadChip (HM450). However, the consistency of MS-HRM results with chip hybridization results has not been examined yet. The aim of this study was to assess the consistency of results of GSTP1, APC and RASSF1 gene methylation analysis in ÐÑ biopsy samples obtained by MS-HRM and chip hybridization. The methylation levels of each gene determined by MS-HRM were statistically different in the group of PC tissue samples and the samples without signs of tumor growth. Chip hybridization data analysis confirmed the results obtained with the MS-HRM. Differences in methylation levels between tumor tissue and histologically intact tissue of each sample determined by MS-HRM and chip hybridization, were consistent with each other. Thus, we showed that the assessment of GSTP1, APC and RASSF1 gene methylation analysis using MS-HRM is suitable for the design of laboratory assays that will differentiate the PC tissue from the tissue without signs of tumor growth.V nastoiashchee vremia sushchestvuet potrebnost' v molekuliarnykh markerakh raka predstatel'noĭ zhelezy (RPZh), utochniaiushchikh stratifikatsiiu patsientov po kategoriiam riska i dopolniaiushchikh faktory klinicheskogo prognoza. Odnim iz molekuliarnykh protsessov, proiskhodiashchikh pri razvitii RPZh, iavliaetsia izmenenie metilirovaniia DNK. Dlia otsenki metilirovaniia genov v laboratornoĭ diagnostike mozhet byt' ispol'zovana chuvstvitel'naia k metilirovaniiu PTsR s analizom krivoĭ plavleniia vysokogo razresheniia (Methylation-Sensitive High Resolution Melting – MS-HRM). Étot metod osobenno perspektiven s tochki zreniia nebol'shogo kolichestva trebuemoĭ DNK (10 ng). Na segodniashniĭ den' nakopleno mnogo dannykh po izucheniiu urovnia metilirovaniia DNK v obraztsakh RPZh, poluchennykh s ispol'zovaniem tekhnologii DNK-chipov “Infinium HumanMethylation450 BeadChip” (HM450). Odnako neizvestno, soglasuiutsia li rezul'taty MS-HRM s dannymi chip-gibridizatsii. Tsel'iu dannoĭ raboty byl sravnitel'nyĭ analiz diagnosticheskoĭ informativnosti metodov MS-HRM i chip-gibridizatsii HM450 pri opredelenii stepeni metilirovaniia genov GSTP1, APC i RASSF1 v obraztsakh, poluchennykh ot bol'nykh RPZh. Pokazano, chto metod MS-HRM pozvoliaet differentsirovat' obraztsy opukholevoĭ tkani RPZh ot obraztsov gistologicheski neizmenennoĭ tkani predstatel'noĭ zhelezy po urovniu metilirovaniia kazhdogo iz genov. Analiz dannykh chip-gibridizatsii podtverdil rezul'taty, poluchennye s pomoshch'iu MS-HRM. Raznosti urovneĭ metilirovaniia genov GSTP1, APC i RASSF1 mezhdu opukholevoĭ tkan'iu i gistologicheski neizmenennoĭ tkan'iu u kazhdogo bol'nogo RPZh, opredelennye MS-HRM ili gibridizatsieĭ na chipakh, soglasovalis' drug s drugom. Takim obrazom, otsenka urovnia metilirovaniia genov GSTP1, APC i RASSF1 s pomoshch'iu MS-HRM mozhet stat' osnovoĭ dlia razrabotki laboratornogo testa, utochniaiushchego diagnostiku RPZh.

Pathology is one of the most dynamically developed medical specialties. The wide spread of whole-slide imaging systems has leaded to the development of microscopic image analysis software. This review shows the possibilities of these programs and their role in the routine work of a pathologist.Патология является одной из наиболее динамически развивающихся медицинских специальностей. Широкое распространение сканеров гистологических препаратов способствовало созданию программного обеспечения, в задачи которого входил анализ получаемого изображения сканируемого препарата. В настоящем обзоре показаны возможности таких программ и их роль в повседневной работе патологоанатома.

The paper is dedicated to the development of expert system for histological prostate cancer diagnosis. The developed system allows to fill the knowledge base and then to use this knowledge base to support physician decision on the histological diagnosis of prostate disease. Keywords: pattern recognition, prostate cancer diagnosis, decision making, decision support system

In the work presented, a method for detecting glomeruli in pictures of histological preparations of the prostate gland is described, the presence of which indicates a malignant neoplasm. Pathological structures at the level of microimages are investigated. The developed method is the result of joint activity of the National Research Nuclear University "MEPhI" and the Moscow State Medical and Stomatological University named after A.I. Evdokimova.