Biomedical subjects

S Szmigielski

Publications and source records attributed to S Szmigielski.

At least 19 recordsLinked to original sources

PubMed2001

Competition of IL-1 and IL-1ra determines lymphocyte response to delayed stimulation with PHA.

BACKGROUND: Human peripheral blood mononuclear cells (PBMC) left in microcultures for 24h without mitogen do not respond to subsequent stimulation with PHA. They regain reactivity if the native culture medium is absorbed with other party lymphocytes or partially replaced with the medium from a PHA-stimulated culture. The observations suggest that, during the incubation, some inhibitory agent had accumulated in the culture medium. AIM: The study was performed to determine the nature of the observed phenomenon in respect of the possible role of monocytes and their products IL-1 and IL-1 receptor antagonist (IL-1ra), and to test for immunodiagnostic purposes the significance of quantifying the lymphocyte response to delayed stimulation with PHA in patients suffering from inflammatory prosesses. METHODS: Lymphocyte response to delayed stimulation with PHA, calculated as the lymphocyte-monokine interaction (LM) index, was determined in the microcultures of PBMC isolated from the blood of healthy donors or of patients with acute tonsilitis. The values of LM indices were compared with the ratios of IL-1ra/IL-1beta concentration estimated by enzyme-linked immunosorbent assay method in the culture supernatants. The influences of exogenous IL-1beta, IL-1ra, anti-IL1ra antibodies and antibiotic cefaclor on the monokine concentrations and on the values of LM index were tested. RESULTS AND CONCLUSIONS: The results show that the level of lymphocyte response to delayed stimulation with PHA (LM index) is inversely proportional to the ratio of IL-1ra/IL-1beta concentration in the culture. The low LM values at high IL-1ra/IL-1beta ratios in PBMC cultures from healthy donors, reversed proportions found in patients' PBMC (acute tonsilitis), and the cefaclor-induced reduction of LM value with correlated increase of the IL-1ra/IL-1beta ratio suggest that the LM assay may prove to be useful for immunodiagnostic purposes.

Adult↗

PubMed2001

[Immunotropic effects of electromagnetic fields in the range of radio- and microwave frequencies].

On the grounds of reviewed literature and the results of own experiments, the authors present current views on the possible immunotropic influence of low energy electromagnetic fields, in the range of radio- and microwave frequencies. They conclude, that a more systematic and multidisciplinary investigations should be undertaken, comprising the wide spectrum of immune homeostatic tasks, including defensive, immunoregulatory and pro-regenerative capabilities of immune system exposed to rapid environmental spread of different electromagnetic emitters.

Animals↗

PubMed2000

Comparison of preoperative embolization followed by radical nephrectomy with radical nephrectomy alone for renal cell carcinoma.

A series of 474 patients with renal cell carcinoma (RCC), who had radical nephrectomy during a period of 15 years, was studied to assess the prognostic significance of various pathologic parameters (tumor stage [pT], lymph node status, metastasis, tumor grade, venous involvement) and value of preoperative embolization of renal artery. There were: 20 (4%) pT1, 204 (43%) pT2, 245 (52%) pT3, and 5 (1%) pT4 patients. All 474 patients underwent nephrectomy including a group of 118 (25%) patients (24 pT2, 90 pT3, and 4 pT4) who underwent preoperative embolization of the renal artery. To compare treatment outcomes in embolized patients with RCC, a group of 116 (24%) nonembolized patients with RCC was selected. This group was matched for sex, age, stage, tumor size, and tumor grade, with the embolized patients (p<0.01). All important prognostic factors were studied as to their influence on survival by the treatment group. The overall 5- and 10-year survival was 62% and 47%, respectively. The 5- and 10-year survival rates were significantly better (p<0.01) for patients with pT2 than for those with pT3 tumors (79% vs. 50% and 59% vs. 35%, respectively). Involvement of regional lymph nodes (N+) was an important prognostic factor for survival in patients with pT3 tumors. The 5-year survival for pT3 N+ was 39%, compared with 66% in those with pT3N0 (p<0.01). Preoperative embolization was also an important factor influencing survival. The overall 5- and 10-year survival for 118 patients embolized before nephrectomy was 62% and 47%, respectively, and it was 35% and 23%, respectively, for the matched group of 116 patients treated with surgery alone (p = 0.01). The most important finding of this study was an apparent importance of preoperative embolization in improving patients' survival. This finding needs to be interpreted with caution and confirmed in a prospective randomized trial.

Adult↗

PubMed1999

Leukocidal toxins of staphylococci.

Leukocidal toxins (synergohymenotropic toxin) are cytotoxins produced by staphylococci (S. aureus and S. intermedius) and consist of two separate components. The toxic effect depends on the synergistic action of two proteins. One of them belongs to class F (e.g. LukF-PV, LukF-R, LukF-I, LukM, HlgB) and the other, to class S (e.g. LukS-PV, LukS-R, LukS-I, HlgA, HlgC). Best known are the toxins produced by S. aureus: gamma-haemolysins, HlgA/HlgB and HlgC/HlgB and leukocidin Panton-Valentine, LukS-PV/LukF-PV (Luk-PV, PVL). Very few data are available concerning the relationship between the production of these toxins and the pathology of staphylococcal infections, because little is known about local and general effects of these leukocidal products in vivo. Frequent isolations of staphylococcal strains producing leukocidal toxins from necrotic skin lesions and furuncles suggest a role of these toxins in the virulence of staphylococci, at least in cutaneous infections. Recent data on mechanisms of cytotoxic effects of staphylococcal leukocidal toxins in vitro as well as effects of leukocidal toxins in vitro are discussed. Cell membranes appear to be a primary target for triggering the lysis of phagocytic cells caused by staphylococcal leukocidal toxins.

Animals↗

PubMed1998

Effect of purified staphylococcal leukocidal toxins on isolated blood polymorphonuclear leukocytes and peritoneal macrophages in vitro.

Bicomponent (fractions S and F) staphylococcal leukocidal toxins (Panton-Valentine leukocidin-Luk and haemolysin gamma-Hlg) were tested for in vitro activity against isolated polymorphonuclear leukocytes (PMNL) and peritoneal macrophages (PMF). For assessment of membrane permeability at subcytolytic concentrations of leukocidin (Luk-S + Luk-F) and haemolysin gamma (HlgA + HlgB) (8-1000 ng/ml), PMNL and PMF were radiolabelled (86Rb, 14C-amino-isobutyric acid (AIB) or 51Cr). All toxins tested caused lysis of human PMNL, although considerable differences were noted in the sensitivity of these cells to Luk and Hlg. Release of 51Cr (at 1000-5000 ng/ml), being a sign of irreversible cell damage and lysis, was preceded, at lower concentrations of the toxins (40 and 200 ng/ml), by the release of large amounts of low-molecular labels--86Rb and 14C-AIB. In another experiment, it was found that release of 86Rb from PMNL incubated with low concentrations of Luk (50 ng/ml) took place after 15-30 minutes of incubation, when no significant amounts of 14C-AIB or 51Cr were released. These findings support the concept of pore formation by staphylococcal leukocidal toxins in membranes of sensitive cells and indicate that a relatively short time is needed for the formation of these pores after binding of the Luk-S and Luk-F components to the membrane.

Adult↗

PubMed1998

Alteration of diurnal rhythms of blood pressure and heart rate to workers exposed to radiofrequency electromagnetic fields.

BACKGROUND: In previous studies we found measurable effects on variability of heart rate and on blood-pressure parameters of workers exposed to radiofrequency electromagnetic fields (EMF)compared with a control population, but none of the effects could be assigned clinical significance. In general, the obtained results strongly suggested that dysregulation of the autonomic control of the circulatory system was occurring. Therefore, it seemed logical that analysis of diurnal rhythms of blood pressure and heart rate, on the basis of data from 24 h recordings, might further support the above hypothesis. OBJECTIVE: The aim of this study was to determine the course of diurnal rhythms of blood pressure and heart rate in a group of workers exposed to various intensities of radiofrequency electromagnetic fields. METHODS: In the study we used 61 healthy workers (aged 30-50 years) who had been exposed to radiofrequency EMF of 0.738-1.503 Mhz and 42 healthy workers at radio-line stations (aged 28-49 years), who had not been exposed to EMF occupationally. The work patterns of these two groups were identical (12 h day working shift, 24 h interval, 12 h night shift and then 48 h rest). During the second day of the rest period 24 h ambulatory blood pressure (ABP) was recorded. For analysis of diurnal rhythms the group of exposed workers was divided into two subgroups: group A of 38 subjects exposed to low intensities of radiofrequency EMF (20-180 V/m) and group B of 23 subjects exposed to high intensities of radiofrequency EMF (200-550 V/m). Parameters of diurnal rhythms of blood pressure and heart rate (acrophase, amplitude and mean) were calculated by performing a least-square fit of a 24 h cosinor (single cosinor analysis) at P < 0.05. RESULTS: Healthy men aged 28-49 years, working on a pattern of 12-24-12-48 h, exhibited typical, well-preserved diurnal rhythms of blood pressure and heart rate with two maxima (at about 1400 and 1700-1800 h) and one minimum (at about 0200-0400 h). For workers exposed to radiofrequency EMF we noted a significant lowering of the amplitudes of rhythms of blood pressure and heart rate (P < 0.01) and a shift of the acrophase to an earlier time (1100-1200 h; P < 0.05). These changes were more pronounced among workers exposed to high intensities of radiofrequency EMF. CONCLUSIONS: Occupational exposure to radiofrequency EMF can result in changes of the diurnal rhythms of blood pressure and heart rate with lowering of their amplitudes and a shift of the acrophase. The clinical relevance of the present finding needs to be investigated in further studies.

Adult↗

PubMed1998

Adjuvant properties of killed Propionibacterium avidum KP-40 in vaccination of dogs against canine parvovirosis.

Immunomodulating and adjuvant properties of Propionibacterium avidum KP-40 (PA), a potent stimulator of the macrophage-monocyte system and inducer of endogenous interferon, were tested in healthy dogs and in dogs vaccinated against canine parvovirosis (CPV). A single subcutaneous injection of PA (0.5 mg/kg b. m.) was administered either 10 days before or simultaneously with CPV immunization. The immunomodulating properties of PA were expressed by enhancement of phagocytic and bactericidal activities of blood leukocytes, accompanied by elevated serum levels of interferon-gamma and interleukin-1 and higher Con-A-induced transformation rates of lymphocytes. Titres of CPV antibodies were significantly (p < 0.01) higher in dogs vaccinated and treated with PA either 10 days prior to or simultaneously with immunization. It is concluded that PA may be applied as a potent and safe adjuvant in vaccination of small animals and additionally, it provides enhancement of non-specific antibacterial and antiviral resistance of the organism.

Adjuvants, Immunologic↗

PubMed1997

Protection and therapy of experimental herpesvirus infections in mice with immunomodulating Propionibacterium avidum KP-40 and/or acyclovir.

Protection and therapy of NMRI mice with experimental herpes virus (HSV-1) encephalitis were investigated using heat-killed, lyophilized Propionibacterium avidum KP-40 (PA) and/or the herpes-specific antiviral substance acyclovir (ACL) as immunomodifier. Poly I:C as a potent macrophage activator was used as a reference compound for PA. Survival of experimental HSV-1 infections during 18 days following the inoculation of viruses was used for the evaluation of the effects of immunotherapy. The applied model of HSV-1 infection resulted in a mortality of about 87% of NMRI mice at 7-16 days following the inoculation of the virus. Treatment with ACL or Poly I:C at the day of HSV-1 infection resulted in a lowering of the mortality rate to about 40% (p < 0.05). PA applied 4 days before HSV-1 infection lowered the mortality rate to 27%, while treatment 2 days after infection was less effective and the mortality rate reached 44%, although still being significantly lower (p < 0.01) than in untreated controls. A combined treatment with ACL and PA on the day of HSV-1 infection protected 93% of animals against the development of clinically detectable herpesvirus encephalitis.

Acyclovir↗

PubMed1997

[The role of selected cell growth factors in the wound healing process].

Growth factors, naturally occurring proteins secreted by different cells or tissues, play very important role in accelerating the wound healing process. Growth factors are mainly released from macrophages, neutrophils, lymphocytes, platelets and fibroblasts and induce cells to migrate, divide or produce other factors required for wound healing. These factors bind to target cells via specific cell-surface receptors and may elicit inhibitory or stimulatory responses, depending on interactions with other factors and the cellular environment into which they are liberated. Systemic growth factors, such as growth hormone and local epidermal growth factor, fibroblast growth factor, platelet-derived growth factor, transforming growth factor i and insulin-like growth factor show to enhance wound healing. Growth factors stimulate fibroblasts proliferation and chemotaxis, collagen synthesis, reepithelialization and angiogenesis. Although growth factors are not widely available for clinical use, many are studied actively to determine their role in the acceleration of wound healing. Results of animal experiments and preliminary clinical trials demonstrate that specific uses growth factors may become the new mode of therapy in wound healing process.

Growth Substances↗

PubMed1996

Cancer morbidity in subjects occupationally exposed to high frequency (radiofrequency and microwave) electromagnetic radiation.

Cancer morbidity was registered in the whole population of military career personnel in Poland during a period of 15 years (1971-1985). Subjects exposed occupationally to radiofrequencies (RF) and microwaves (MW) were selected from the population on the basis of their service records and documented exposures at service posts. The population size varied slightly from year to year with a mean count of about 128,000 persons each year; each year about 3700 of them (2.98%) were considered as occupationally exposed to RF/MW. All subjects (exposed and non-exposed to RF/MW) were divided into age groups (20-29, 30-39, 40-49 and 50-59). All newly registered cases of cancer were divided into 12 types based on localisation of the malignancy; for neoplasms of the haemopoietic system and lymphatic organs an additional analysis based on diagnosis was performed. Morbidity rates (per 100,000 subjects annually) were calculated for all of the above localisations and types of malignancies both for the whole population and for the age groups. The mean value of 15 annual rates during 1971-1985 represented the respective morbidity rate for the whole period. Morbidity rates in the non-exposed groups of personnel were used as 'expected' (E) rates for the exposed subjects, while the real morbidity rates counted in the RF/MW-exposed personnel served as 'observed' (O) rates. This allowed the calculation of the observed/expected ratio (OER) representing the odds ratio for the exposed groups. The cancer morbidity rate for RF/MW-exposed personnel for all age groups (20-59 years) reached 119.1 per 100,000 annually (57.6 in non-exposed) with an OER of 2.07, significant at P < 0.05. The difference between observed and expected values results from higher morbidity rates due to neoplasms of the alimentary tract (OER = 3.19-3.24), brain tumours (OER = 1.91) and malignancies of the haemopoietic system and lymphatic organs (OER = 6.31). Among malignancies of the haemopoietic/lymphatic systems, the largest differences in morbidity rates between exposed and non-exposed personnel were found for chronic myelocytic leukaemia (OER = 13.9), acute myeloblastic leukaemia (OER = 8.62) and non-Hodgkin lymphomas (OER = 5.82).

Adult↗

PubMed1993

Transrectal hyperthermia as palliative treatment for advanced adenocarcinoma of prostate and studies of cell-mediated immunity.

During a fifteen-month period, 15 patients with progressive adenocarcinoma of the prostate (CaP) were treated with transrectal microwave hyperthermia (TRHT). There were 5 Stage T4 and 11 Stage T3 patients including 6 patients with skeletal metastases. Nine of the patients had severe and 6 had moderately severe signs and symptoms of CaP. TRHT was given six times at 2,450 MHz with temperature controlled at 43.5 degrees for thirty minutes. Cell-mediated immunity tests were performed before TRHT and at two, four, and six months post-therapy. The results of these tests were compared with those of 15 patients with benign prostatic hyperplasia (BPH) treated with the same TRHT and with 30 untreated normal volunteers. TRHT was well tolerated with mild acute toxicity noted in 3 patients (20%). Of the 15 patients treated, 2 (13%) showed scintigraphic evidence of regression of bone metastases. Five patients survived more than five years since treatment, and in 3 patients there was no evidence of CaP. A decrease of marked or moderate degree in signs and symptoms of CaP was noted in 8 patients (53%). The results of cell-mediated immunity tests were of interest. The 15 CaP patients prior to TRHT had lower OKT4/OKT8 ratio, lower PHA transformation index, and lower Con-A induced T-cell suppressor activity as compared with the 15 BPH patients and 30 healthy volunteers, who had normal immune parameters (p < 0.01). Following TRHT there was a significant increase in the monitored immune parameters noted in the 15 CaP patients (p < 0.01). This immune stimulation peaked at two months and gradually decreased to near pretreatment levels at six months. In the 15 BPH patients post-TRHT changes in immune tests were less apparent. The results of this small study, if confirmed, could be of clinical importance in patients with advanced prostate cancer.

Actuarial Analysis↗

PubMed1993

Prophylactic application of Propionibacterium avidum KP-40 in swine with acute experimental infections. II. Bacterial infections: pleuropneumonia and swine erysipelas.

The potent immunomodifier Propionibacterium avidum KP-40 (PA) demonstrated prophylactic potency in swine infected experimentally with Haemophilus (Actinobacillus) pleuropneumoniae or Erysipelothrix rhusiopathiae. Animals received PA either together with the respective vaccine or PA only; 3 resp. 4 weeks later all animals were inoculated with virulent pathogens. Eight of 10 swine immunized with inactivated pleuropneumonia vaccine developed mild-moderate forms of infection with temporary stagnation of body weight; application of the vaccine together with PA lowered the morbidity rate to 1 of 10 (p < 0.05). Also in non-vaccinated swine infected with pleuropneumonia or erysipelas PA application resulted in milder clinical symptoms, faster recovery and a larger gain of body weight.

Actinobacillus Infections↗

PubMed1993

Prophylactic application of Propionibacterium avidum KP-40 in swine with acute experimental infections. I. Viral infections--Aujeszky's disease and classical swine fever.

The usefulness of the prophylactic application of Propionibacterium avidum KP-40 (PA), a potent stimulator of the macrophage-monocyte system and inducer of endogenous interferons, was demonstrated in swine infected experimentally with Aujeszky's disease or classical swine fever viruses. Some of the infected animals were preimmunized with respective vaccines containing live, attenuated viruses. In vaccinated and non-vaccinated swine infected with Aujeszky's disease virus, pretreatment with PA lowered the morbidity rate, shortened the period of fever and fastened the recovery. Infection with classical swine fever virus resulted in 100% mortality of PA-pretreated non-vaccinated swine, but the length survival of the animals was significantly longer (p < 0.05).

Adjuvants, Immunologic↗

PubMed1992

Adjuvant properties of propionibacterium avidum KP-40 in vaccination against endemic viral and bacterial infections. I. Swine immunized with live attenuated Aujeszky's disease virus vaccine and experimentally infected with virulent viruses.

Forty 5-month old swine were treated with immunomodulating Propionibacterium avidum KP-40 (PA) and/or immunized with live attenuated Aujeszky's disease (AD) virus vaccine (SuivacA); 8 weeks later all animals were infected with virulent AD viruses (NIA-3). Seven of 10 swine vaccinated without PA developed mild/moderate symptoms of infection with 3- to 5-day fever and a temporary halt in weight gain. Application of PA together with the vaccine lowered the morbidity rate, shortened the period of fever and speeded recovery. Only low levels of virus-neutralizing IgG antibodies were found in vaccinated swine and application of PA did not influence antibody titers.

Adjuvants, Immunologic↗

PubMed1992

Adjuvant properties of Propionibacterium avidum KP-40 in vaccination against endemic viral and bacterial infections. II. Swine immunized with inactivated Haemophilus pleuropneumoniae vaccine and experimentally infected with different virulent serotypes of H. pleuropneumoniae.

Forty 3-month old swine were treated with immunomodulating Propionibacterium avidum KP-40 (PA) and/or vaccinated with a formalin-inactivated mixture of serotypes 1, 3, 5 and 9 of Haemophilus pleuropneumoniae (Pleurovac). Three weeks after revaccination all animals were inoculated with viable single serotypes of Haemophilus pleuropneumoniae. The IgG antibodies induced by vaccination agglutinated all serotypes of Haemophilus pleuropneumoniae, except for serotype 5. Antibody titers were not influenced by the application of PA together with the vaccine. Infection of vaccinated piglets resulted in the development of pleuropneumonia in 8 out of 10 animals, while vaccination together with application of PA lowered the morbidity rate to 1 out of 10 (p < 0.05). The usefulness of a PA prophylaxis was also demonstrated in non-vaccinated piglets infected with Haemophilus pleuropneumoniae. Because of the considerable variability of strains and serotypes of Haemophilus pleuropneumoniae and the generally low prophylactic potency of pleuropneumonia vaccines it is concluded that long-lasting enhancement of non-specific antiinfective resistance caused by PA may lower the risk of endemic infections in vaccinated piglets.

Actinobacillus Infections↗

PubMed1992

Adjuvant properties of Propionibacterium avidum KP-40 in vaccination against endemic viral and bacterial infections. III. Swine immunized with live attenuated Erysipelothrix rhusiopathiae vaccine and experimentally infected with virulent strains R203 and R270B of E. rhusiopathiae.

Fifty 4-month old piglets were treated with immunomodulating Propionibacterium avidum KP-40 (PA) and/or immunized with live attenuated Erysipelothrix rhusiopathiae vaccine (Orvac). Four weeks after vaccination all animals were inoculated with viable Erysipelothrix rhusipathiae. The vaccine induced the appearance of high titers of specific IgG antibodies with peak values (1:115-1:200) three weeks after immunization. Administration of PA together with the vaccine did not influence antibody titers. Analysis of the course of experimental erysipelas infection in vaccinated and/or PA-treated swine revealed the prophylactic and beneficial effects of PA. PA-treated animals showed a significantly lower lethality rate than untreated controls and the course of the disease was considerably milder, with a shorter period of fever and a faster recovery. Vaccination provided good protection of swine against the development of erysipelas and therefore, the only significant difference in animals treated with PA applied together with the vaccine was a higher gain of body mass after infection.

Adjuvants, Immunologic↗

PubMed1992

Immunotherapy of chronic active viral hepatitis B with propionibacterium granulosum KP-45 (a 5-year follow-up report).

In the period 1982 to 1984, 14 HBS-AG-positive patients with chronic active hepatitis B were treated monthly with a cell wall preparation (5 or 10 mg) of Propionibacterium granulosum KP-45 (PG), intravenously administered for a period of 6 to 10 months. All 14 patients were monitored by serological and biochemical tests as well as liver biopsy two, three and five years after completing immunotherapy with PG. During this period the patients received neither a specific antiviral, corticosteroid or interferon therapy, nor PG. Re-appearance of HBSAG or HBeAG was never seen in patients who were already free from the antigens one year after completing PG immunotherapy. During the 5-year follow-up, spontaneous improvement in serological and morphological (liver biopsy) parameters of chronic virus B hepatitis occurred in six patients. Five years after completion of PG immunotherapy, only four of the 14 patients showed trace amounts of serum HBSAG (carriers), and in two low levels of anti-HBeAG were present, while the whole group showed a decreasing tendency and serum anti-HBc was still detectable in six patients. HBeAG- and DNA-polymerase-positivity was absent in all patients. Microscopic examination of liver biopsies 5 years after PG immunotherapy showed mild symptoms of chronic hepatitis with inflammatory infiltration, non-active cirrhosis, but without massive periportal and/or multilobular necrosis and trace amounts of HBsAG and HBcAG in hepatocytes only in the four carriers. The remaining 10 patients were free of symptoms of active hepatitis and/or active cirrhosis, but all the patients had moderate to intensive fibrosis in their liver biopsies.

Adjuvants, Immunologic↗

PubMed1991

A comparison of transurethral and transrectal microwave hyperthermia in poor surgical risk benign prostatic hyperplasia patients.

From 1987 to 1989, 36 poor surgical risk patients with benign prostatic hyperplasia (BPH) were treated with transrectal or transurethral microwave hyperthermia. Most of the 36 patients treated (85%) had severe signs and symptoms of urinary outflow obstruction. Of the patients 22 (61%) underwent transrectal and 14 (39%) underwent transurethral hyperthermia. Followup ranged from 10 to 28 months (mean 19 months) for the transrectal hyperthermia group and 7 to 16 months (mean 10 months) for the transurethral hyperthermia group. The patients were given 6 hyperthermia sessions of 30 minutes each with the temperature controlled on the rectal or urethral surface at 45C. Hyperthermia was well tolerated with mild acute toxicity and no late complications were observed. In the important subjective and objective parameters, major improvement was noted more frequently in the 14 transurethral than in the 22 transrectal hyperthermia treated patients (p less than 0.05). The Food and Drug Administration severity score, prostate volume, post-voiding residual volume and urethral flow showed substantial improvement in 79, 86, 79 and 79%, respectively, of the 14 transurethral hyperthermia treated patients compared to 41, 45, 82 and 82%, respectively, for the 22 transrectal hyperthermia treated patients. A prospective randomized trial comparing transrectal and transurethral hyperthermia is required to define the role of each treatment mode in patients with BPH.

Aged↗