The development of oxidative and nitrative stress and the processes of free radical oxidation are associated with many pathological processes. Damage of any origin leads to the activation of free radical processes not only in the place of damage, but also in the whole organism. The aim of the study is to assess the state of lipid peroxidation, content of GSH and GSSG and the activity of NO-synthase and arginase in lymphocytes and peripheral blood serum in men with erectile dysfunction due to combat trauma. The research was conducted on peripheral blood lymphocytes of men injured as a result of combat operations (shrapnel and bullet wounds) in the Russian-Ukrainian war, and who were treated at the Military Medical Clinical Center of the Western Region (Lviv, Ukraine). The research group of men with combat injuries was divided into two age groups: men aged 20–39 years and men aged 40–53 years. The MDA content in the blood serum of patients of both age groups was 1.35 times higher than in the control group. In peripheral blood lymphocytes, the MDA content in patients of the young age group was 1.27, and in patients of the middle age group in 1.39 times higher than in the control group. Simultaneously, no significant changes in the concentration of oxidized glutathione in blood serum and blood lymphocytes were found between men with erectile dysfunction due to combat trauma and healthy men. GSH content in blood serum in patients of both age groups was significantly lower than in the control group. The arginase/NOS ratio in blood serum was 9.75 times lower in the young age group and in 20.45 times lower in the middle age group compared to healthy men. It was established that in the blood serum and blood lymphocytes of men with erectile dysfunction due to combat trauma, processes of lipid peroxidation were intensified and the GSH level was reduced. The GSH/GSSG ratio was reduced only in blood serum. It was found that the oxidative stress is associated with development of nitrative stress. The arginase/NOS ratio was shifted towards increased NOS activity. Activation of iNOS was accompanied by significant inhibition of cNOS. Further study of biochemical mechanisms is important to understand the triggers of erectile dysfunction due to combat
trauma.
Keywords: trauma; erectile dysfunction;MDA content; glutathione;NO-synthase; arginase. 

Erectile dysfunction and the associated quality of life are a pressing social and medical problem for millions of people. The basis of
the work was the results of a survey of 298 men injured as a result of combat operations (shrapnel and bullet wounds) using the questionnaires of the International Index of Erectile Function-5 (IIEF-5) and the SF-36 Health Status Survey (SF-36) questionnaire to characterize the quality of life. The research group was divided into two: men aged 20-39 years (group 1) and men aged 40-53 years (group 2). The control group consisted of 48 clinically healthy men without complaints of sexual dysfunction or cardiac, neurological or endocrinological pathology. It is shown that men aged 20-39 years have a mild form of ED where the total score is 19.57 ± 0.44. Men of the 2nd group aged 40-53 years also have a mild form of ED, but the total score is much lower and is 17.74 ± 0.41. Patients of both age groups affected by hostilities suffer from both mental and physical health components. Indicators such as general health, role functioning due to physical condition, and pain intensity have probably lower values compared to the contol group. Lower indicators of role functioning due to physical condition indicate limitations in everyday life due to unsatisfactory physical condition. The decrease in the physical functioning index has statistically significant differences only in patients of the 2nd observed group. Thus, a mild form of erectile dysfunction is observed in men injured as a result of hostilities. No significant differences in the severity of erectile dysfunction were found betweenmale war victims of two age groups. All IIEF-5 domains were significantly reduced in men affected by combat operations. It has been proven that the physical and mental components of health suffer in victims of hostilities. Against the background of a decrease in all indicators on the scales of the physical component of health, general health and role functioning caused by physical condition lag behind the most. In the psychological domain, the most pronounced changes are recorded in such components as mental health, vital activity and social functioning. Сorrelation analysis revealed the significant correlation between physical functioning and role functioning caused by emotional state (r =+0.64; P < 0.05).
Keywords: men with shrapnel and bullet wounds; erectile dysfunction; quality of life;SF-3

УДК 616.697:616.72-002.77-092:612.015.11]-07

According to modern ideas, the development of pathological processes in the body, in particular relat-ed to infertility, is accompanied by a violation of the mechanisms of antioxidant protection of cells. Hyperproduction of reactive oxygen species (ROS) is found in many pathological conditions, both related to the reproductive system and not directly related to it. Excessive ROS production, is thought, to be caused by an imbalance between prooxidants and the antioxidant system and causes damage to the sperm membrane, chromosome DNA, and initiates sperm apoptosis that leading to infertility.The aim – to study of the functional state of the pro- / antioxidant system in the seminal fluid and serum of infertile men with concomitant pathology.Material  and  Methods. The studies were performed on the serum and seminal fluid of infertile men aged 22–48 years with diagnosed idiopathic infertility (n=23) and rheumatoid arthritis (n=22). The control group consisted of 27 men of the same age. The ejaculate was analyzed according to WHO recommendations (2010). Determination of malonic dialdehyde (MDA) concentration was performed based on its interaction with 2-thiobarbituric acid. The state of the antioxidant system of semen and blood serum was concluded based on determining the total antioxidant activity by enzyme-linked immunosorbent assay using a commercial test system manufactured by Elabscience (ELISA, USA). Results. It was found that in patients with autoimmune pathology, the concentration of MDA in the serum exceed-ed the control group by 2.25 times, and in idiopathic infertility – by 2.16 times. In semen, the content of MDA in men with infertility due to autoimmune pathology is likely to exceed 4 times the control values. In patients with idiopathic infer-tility, the content of MDA in the seminal fluid was within normal limits. Against the background of intensification of lipid peroxidation processes, the overall antioxidant activity decreases. At autoimmune pathology it decreases in 8.1 times.Conclusion. Oxidative stress is one of the immunopathogenetic mechanisms of development of male infertility against the background of autoimmune pathology and idiopathic infertility.

UDC 612.616:612.015.11:612.014.484

About 15% of married couples in the world suffer from infertility. In approximately 50% of cases, the main problem lies in the male factor. Male infertility is a multifactorial syndrome that encompasses a wide range of disorders. Infertility in men without an established history is called "idiopathic infertility". The aim of the work was to compare reproductive function of men according to spermogram indicators for both a control (normozoospermia) and an experimental (idiopathic infertility) groups. The study consisted in studying spermogram indicators in patients of both groups according to WHO recommendations and comparing them with each other and with reference values. Comparison of physicochemical indicators of ejaculate revealed that the volume of ejaculate in groups II and I did not reliably differ from each other, as did the pH indicator. The indicators of the time of dilution of ejaculate in persons with idiopathic infertility significantly increased (by 1.4 times) in comparison with men of the control group. Reliable violations of the quality indicators of ejaculate, characterized by a decrease in sperm motility by 1.6 times, were revealed. The number of immobile spermatozoa was 1.7 times higher in idiopathic infertility compared to control values. A 1.8-fold decrease in the concentration of fructose in the ejaculate correlated with pronounced processes of sperm motility and viability impairment. The indicator of the concentration of citric acid, which reflects the functional state of the prostate gland and the endocrine function of the testicles, was 1.7 times higher in patients with idiopathic infertility compared to the control group. The content of zinc in seminal fluid differs most between infertile men and men of the control group, it was 3.4 times lower in men with idiopathic infertility. Thus, the obtained data on the indicators of spermograms denote that reproductive problems in men with idiopathic infertility consist in a reliable violation of the qualitative indicators of ejaculate especially in reduced mobility. Which correlates with changes in the index of liquefaction time, which increases and biochemical indicators (decrease in the concentration of fructose, citrate and zinc) compared to ejaculate indicators in men with normozoospermia.