Vol 68, No 8 (2013)

OBSTETRICS AND GYNAECOLOGY: CURRENT ISSUES

ONCOGYNECOLOGICAL ASPECTS ОF ADNEXAL MASSES

Gasparov A.S., Zhordania K.I., Payanidi Y.G., Dubinskaya E.D.

Abstract

Adnexal masses are frequently found in both symptomatic and asymptomatic women. The frequency of them is 7,8% in reproductive aged women and 2,5–18% in postmenopausal patients. Aim: to investigate clinical significance of the Risk of Malignancy Index (RMI) and to compare it with histological findings in patients with adnexal masses. Patients and methods: 345 patients with adnexal masses were evaluated. Depending on the menopausal status, serum CA-125 level and ultrasonographic findings RMI scores were calculated for each of patients. Results: according to RMI all the patients were divided in to two groups: first group — 283 (62%) of patients with RMI less then 200 and the second group — 52 (38%) women with RMI more then 200. The patients of the second group were referred to the oncologist. Among the patients with RMI <200, 137 (48,4%) endometriomas, 73 (25,8%) serous cystadenoma, 45 (15,9%) dermoid cysts, 22 (7,8%) paraovarian cysts, 2 (0,7%) adenocarcinoma were detected after histological examination. In patients with RMI >200, 25% of benign ovarian tumors, 34,6% of borderline and 40,4% of malignant tumors were verified. Conclusions: RMI when used in the presence of a pelvic mass is a useful triage tool to determine those women who should be referred to a gynaecological oncologist. During laparoscopy, in cases of intraoperative malignancy suspicion staging should be performed: videorecord of the surgery, biopsy of the adnexal mass and contralateral ovary, biopsy of the omentum and peritoneum, and aspiration of the peritoneal fluid for cytological examination.

Annals of the Russian academy of medical sciences. 2013;68(8):9-13
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ROLE OF THE GENETIC FACTORS, DETOXICATION SYSTEMS AND OXIDATIVE STRESS IN THE PATHOGENESIS OF ENDOMETRIOSIS AND INFERTILITY (REVIEW)

Dubinskaya E.D., Gasparov A.S., Fedorova T.A., Lapteva N.V.

Abstract

The aim of this paper is to provide a systematic review of the role of the genetic factors, detoxication systems and oxidative stress in the pathogenesis of endometriosis and infertility. Endometriosis and infertility are still both the most uncommon diseases in gynecology. Many aspects of female reproductive function are strongly influenced by genetic factors, and numerous studies have attempted to identify susceptibility genes for disorders affecting female fertility such as polycystic ovary syndrome, endometriosis, fibroids, cancer (ovarian, vulvar, cervical), premature ovarian failure, recurrent pregnancy loss and pre-eclampsia. The most solid evidence linking specific polymorphisms to endometriosis is showed by the studies investigating a phase II detoxification enzyme. No data were found concerning influences of the genetic factors on the female infertility. Contrary, a lot of studies devoted to the genetic factors of male infertility are presented. It’s known that endometriosis associated with increased systemic oxidative stress. The implication of increased systemic oxidative stress in disease progression or the association with other oxidative stress-related pathologic conditions needs to be addressed in further studies. The majority of studies suggest a reduced antioxidant capacity in infertile women with endometriosis. In the present review we discussed the role of the genetic factors in the pathogenesis of endometriosis and infertility. NAT2 polimorphism, xenobiotic methabolism and exogenous factors are somehow related with these diseases. An altered balance between pro-oxidant and antioxidant activities may have an impact on folliculogenesis and adequate embryo development.

 

Annals of the Russian academy of medical sciences. 2013;68(8):14-19
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THE MICROMETRIC CHARACTERISTIC OF PLACENTAE’S VILLIFEROUS TREE IN WOMEN IN CHILDBIRTH WHO HAVE GIVEN BIRTH TO NEWBORNS WITH DEVELOPMENTAL ANOMALIES

Seidbekova F.O.

Abstract

One of the actual problems of modern obstetrics is fetoplacental insufficiency. The aim of the Research is micrometric characteristic of placentas villiferous tree of women at 38-40 weeks, who gave birth to babies with congenital developmental abnormalities. Patients and methods. The resulting material was distributed in 3 groups. The control group - 40 placentas, conditional control group - 45 placentas, the basic group - 64 placentas. The results of a complex analysis have shown the presence of degenerative, dystrophic, proliferative disorders of the placentas in the basic group. Conclusions: our data showed the presence of ischemic and necrotic areas with the presence of immature terminal villi.

 

Annals of the Russian academy of medical sciences. 2013;68(8):20-23
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INFECTIOUS DISEASES: CURRENT ISSUES

EPIDEMIOLOGY-BIOLOGICAL FEATURES OF THE ACUTE INTESTINAL INFECTIONS CAUSED BY STAPHYLOCOCCUS AUREUS

Golubnichaya V.N., Malysh N.G.

Abstract

Nowadays the structure of acute intestinal infections pathogens changed substantially. It is caused by constant evolution of bacteria and involvement of the opportunistic pathogens in the pathological processes. The aim of the study was to investigate the prevalence of the acute intestinal infections caused by staphylococci in the North-Eastern region of Ukraine, to determine the pathogenic factors in isolated pathogens. The materials for the study were the data of statistical reporting of Sumy regional sanitary-epidemiological station. Biological properties of the 50 Staphylococcus aureus strains were investigated. In the work used The descriptive and analytical techniques of the epidemiological, bacteriological and statistical methods were used. In the 2007–2012 the incidence of acute intestinal infections caused by staphylococci was in the range 17,1–20,3 on the 100 thousand. 2 year-old children were prevailed in the age structure. The largest numbers of cases were recorded in January, February, April, June and August. Strains of Staphylococcus aureus, isolated from the patients were characterized by a wide spectrum of pathogenic and persistence factors. Anti-lisozym activity was in 100% of the investigated cultures, anti-interferon and anti-complement activity were detected in 96,0 and 64,0% stains, ability to adhesion was present in 36,0% stains. At the same time anti-lisozym, anti-interferon and anti-complement activity were showed in the 52,0% stains of the Staphylococcus aureus. These data characterize negatively predicted for the near future regional trends in morbidity.



Annals of the Russian academy of medical sciences. 2013;68(8):24-27
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EXPERIMENTAL WHOOPING COUGH OF NONHUMAN PRIMATE

Kubrava D.T., Medkova A.Y., Sinyashina L.N., Shevtsova Z.V., Matua A.Z., Kondzharia I.G., Barkaya V.S., Elistratova Z.V., Karataev G.I., Mikvabia Z.Y., Gintsburg A.L.

Abstract

Despite considerable success in study of Bordetella pertussis virulence factors, pathogenesis of whooping cough, duration of B.pertussis bacteria persistence, types and mechanisms of immune response are still keep underinvestigated. It can be explained by the absence of adequate experimental animal model for pertussis study. Our study estimates clinical and laboratory parameters of whooping cough in non-human primates of the Old World in the process of intranasal infection by virulent B.pertussis bacteria. Also the duration of B.pertussis bacteria persistence in animals was investigated. 14 animal units of 4 species of non-human primates of the Old World were used for intranasal infection. The examination of infect animals included: visual exploration of nasopharynx, thermometry, clinical and biochemical blood analyses, identification of B.pertussis, using microbiologic and molecular genetic analyses, estimation of innate and adoptive immune factors.  The development of infectious process was accompanied by generation of B.pertussis bacteria, catarrhal inflammation of nasopharyngeal mucosa, leucocytosis, hypoglycemia specific for pertussis, and activation of innate and adaptive immunity for all primates regardless of specie were seen. While repeated experimental infection in primates single bacterial colonies were registered during only first week after challenge. It occurs like the absence of inflammation of nasopharyngeal mucosa and the lack of laboratory marks of whooping cough, recorded after first challenge. The evident booster effect of humoral immunity was observed. As a model for investigation of B. pertussis bacteria persistence and immune response against whooping cough we suggest the usage of rhesus macaque as more available to experiments.

 

Annals of the Russian academy of medical sciences. 2013;68(8):28-33
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STOMATOLOGY: CURRENT ISSUES

MODERN CONCEPTS OF ETIOLOGY, PATHOGENESIS AND TREATMENT APPROACHES TO ENDO-PERIO LESIONS

Grudyanov A.I., Makeeva M.K., Pyatigorskaya N.V.

Abstract

A combination of periodontitis and pulp or periapical tissues inflammation in one tooth is known as endo-periodontal lesions. Such kind of lesion is serious problem of modern dentistry. It was found that pathogenic microflora of periodontal pocket and root canal of tooth with eno-perio lesion is almost the equal and consist of anaerobic microorganisms. Pathogenic effects have not only microorganisms but also their life products. Apical foramen, lateral and additional canals are physiological ways for pathogens migration. Inflammatory processes in these structures complicate each other. Lack of information among dentists about treatment possibilities of endo-perio lesions is a main reasons of extraction such kind of teeth. Simultaneous elimination of pathogens both from periodontal pocket and root canal is a key factor for effective treatment. Periodontal status is main factor for prognosis of tooth with endo-perio lesion, because of it treatment of endo-perio lesions should consist of two stages: infection elimination and regeneration of tooth-supported structures.

 

Annals of the Russian academy of medical sciences. 2013;68(8):34-36
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PHTHISIOLOGY: CURRENT ISSUES

NANOPARTICLES AS DRUG DELIVERY SYSTEM FOR ANTITUBERCULOUS DRUGS

Sanzhakov M.A., Ipatova O.M., Torkhovskaya T.I., Prozorovskii V.N., Tikhonova E.G., Druzhilovskaya O.S., Medvedeva N.V.

Abstract

The increase of tuberculosis incidence in last decade stimulated elaboration of both new antituberculous drugs and also searches of optimizing delivery systems for existing drugs. It is determined by their side effects and low bioavailability of effective first line  drug rifampicin. Various nanosystems for transport of antituberculous drugs are considered on the basis of various polymers, liposomes, lipid nanoparticles, nanoemulsios, nanosuspensions, dendrimers, cyclodextrines. Influence of drug incorporation into nanoparticles, most often for rifampicin, on pharmacokinetics and efficiency in tuberculosis models is discussed. The most of works are devoted to polymer nanoparticles for oral administration where increased circulation time and efficiency were shown. The best results were observed after drug inclusion into solid lipid nanoparticles. The liposomes formulations were investigated mostly for inhalation and injection administrations. Positive results were also observed. Authors underline the viability of incorporation of antituberculous drugs into phospholipid nanoparticles that may increase intestinal absorption and bioavailability. It is confirmed by authors’ own data that showed increase of rifampicin efficiency after their incorporation into such nanoparticles.

 

Annals of the Russian academy of medical sciences. 2013;68(8):37-44
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ROLE OF HEPATOPROTECTORS AND IMMUNOMODULATORS IN REGULATION OF HEPATOCYTE APOPTOSIS INDUCED BY ANTITUBERCULOSIS TREATMENT

Sukhanov D.S., Bazhanova E.D., Teplyi D.L.

Abstract

It was currently shown that hepatopathy due to drug toxicity is associated with increased apoptosis of hepatocytes. Therefore, development of drugs which regulate cell death is of great importance. Aim: to involve some hepatoprotectors (ademethionine, reamberin, remaxol) and immunomodulators (cycloferon) into regulation of apoptosis in experimental models of liver first-line antituberculousis drugs (isoniazid, rifampicin, pyrazinamide). Materials and methods: levels of apoptosis (TUNEL), expression of CD95 (receptor of tumor necrosis factor ― by immunohistochemistry), expression of caspase-8, caspase-3 and p53 (Western-blotting) were measured. Results: exposition of first-line antituberculousis drugs leads to dysthrophia of liver parenchyma cells with increased apoptosis of hepatocytes and activation of CD95, caspase-8 (external way) and overexpression of p53 and caspase-3. It was found that reamberin, cycloferon and remaxol have hepatoprotective effect improving liver histology; ademethionine administered by intraperitoneal injection showed no positive effects. Reamberin demonstrated apoptosis-inhibiting effect in the experiment whereas other drugs were found to be apoptosis inductors for hepatocytes in toxic hepatopathy. Conclusions: regulation of apoptosis by cycloferon and remaxol mediated by external and p53-dependent pathway is confirmed by increased expression of CD95 and p53 protein. Ademethionine might induce apoptosis by the intrinsic pathway.

 

Annals of the Russian academy of medical sciences. 2013;68(8):45-50
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EDITORIAL

INTERNATIONAL APPROACHES TO THE REGULATION OF CELL THERAPY PRODUCTS

Pyatigorskaya N.V., Tulina M.A., Aladysheva Z.I., Beregovykh V.V.

Abstract

This article is a review of the main methods and approaches used in regulation of cell therapy products in the United States of America, Canada, European Union, Australia, Japan and South Korea. Intensive developments of scientific and technological aspects in stem cell and tissue engineering have led to the wide use of human cells and tissues for the treatment of various diseases and injuries of organs and tissues. Drug regulatory agencies of different countries are working on implementation of a risk-based legal framework with some common features. In many countries there is a multilevel control system that assures quality and safety of used  cell products. Competent authorities establish strict requirements  both to safety of the products and to the implemented standards of good laboratory, manufacturing, clinical and tissue practices.   

Annals of the Russian academy of medical sciences. 2013;68(8):4-8
pages 4-8 views

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