Vol 69, No 11-12 (2014)

РATHOPHYSIOLOGY: CURRENT ISSUES
BLOOD COAGULATION AND FIBRINOLYSIS DISTURBANCES IN ACUTE INFLAMMATORY RESPONSE IN PATIENTS WITH SEPTIC TUBOОVARIAL FORMATIONS
Afanas'eva G.A., Simonova A.N.

Abstract

Objective: There are no any systemized studies of relationship between the coagulative haemostasis’ disorders and metabolic and cytokine status in patients with septic tuboovarial formations. The aim of the present work was to study the mechanisms of blood coagulation disorders and their relationships with changes of cytokine status and acute phase of inflammatory response in septic tubovarial formations in women. Methods: 32 patients with purulent tubovarial formations and 30 healthy women were examined. Results: Shortening of activated partial thromboplastin, prothrombin and thrombin clotting time, increasing the duration of XIIa-kallikrein-dependent fibrinolysis, as well as the elevation of paracoagulation products in blood plasma were observed. IL-1β (p =0.000023), TNF-α (р <0.001), C-reactive protein (р <0.001), haptoglobin (р <0.001) and fibrinogen (р <0.001) levels were higher in peripheral blood of patients in comparison with healthy women. Accumulation of lipid hydroperoxides (р <0.001) and malonic dialdehyde (р <0.001) occurred in the blood plasma of patients. Serum albumin (р <0.001) and transferring (р <0.001) levels were lesser in patients with purulent tuboovarial formations in comparison with healthy women. Conclusion: The obtained results showing an initiating role of cytokine and oxidative metabolic status changes in blood coagulation potential’s and fibrinolysis activity’s disorders developing. This biochemical signs may be used as objective criteria which may serve to determine the risk of thrombosis in case of acute inflammatory response in women with purulent tubovarial inflammation.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):5-10
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EVALUATION OF LIPID PEROXIDATION – ANTIOXIDANT PROTECTION IN PERIMENOPAUSAL WOMEN WITH SLEEP DISORDERS
Kolesnikova L.I., Madaeva I.M., Semenova N.V., Solodova E.I., Grebenkina L.A., Darenskaya M.A.

Abstract

Objective: Our aim was to assess lipid peroxidation antioxidant protection with the definition of the oxidative stress coefficient in perimenopausal women with sleep disorders. Methods: 45 perimenopausal women (mean age 49.1±0.32) were examined: 26 patients with sleep disorders, 19 — without sleep disorders. Evaluation of sleep disorders was conducted using a questionnaire of Stanford Centre for the Study of Sleep, test for assessment subjective severity of insomnia, the questionnaire for the quantitative assessment of the risks of sleep apnea, the scale for quantifying the degree of daytime sleepiness Epworth. We used spectrophotometric methods for lipid peroxidation – antioxidant system investigation. Statistical analysis was performed by non-parametric tests. Results: In perimenopausal women sleep disorders often presents falling asleep difficulties (93.3%) and morning awakening difficulties (78.8%). Complaints of snoring detected in 33.3% of patients. Insomnia severity index was 21.3±0.54, the total score on the Epworth scale — 12.2±0.42. The study results showed increase secondary products of lipid peroxidation (ketodienes and coupled trienes) levels by 2.2 times (р <0.05). Coefficient oxidative stress in women with sleep disorders is higher by 2 times than in group without sleep disorders. Conclusion: In perimenopausal women sleep disorders are associated with oxidative stress, which is pathogenic rationale for inclusion in the complex therapy of these patients drugs that inhibit of lipid peroxidation activation.

Annals of the Russian academy of medical sciences. 2014;69(11-12):11-16
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ONTOGENETIC ASPECTS OF CHANGING LYSOZYME ACTIVITY AFTER ACUTE SOMATIC PAIN
Ovsyannikov V.G., Boichenko A.E., Blikyan M.V., Alekseev V.V., Alekseeva N.S., Abramova M.V.

Abstract

Aim: to study impact of acute somatic pain on lysozyme activity of different ages rats: newborn, rats after eye opening, month of age rats, adult and old rats. Methods: Lysozyme activity determined before pain irritation and after 2, 30, 60, 120, 180 min using Dorofeychuk’s method in our modification. Pain effect was modeling by electrical stimulation. Results: activity of lysozyme was 0.434±0.01 units in intact newborn rats, it was higher than in adult rats — 0.260±0.01 units (p <0.001) and it was unchanged during the experiment. We found low lysozyme activity in rats
after eye opening — 0.015±0.003 units and it was stable during the experiment. Month of age rats had diphasic reaction: lysozyme activity was 0.191±0.01 units in intact rats, it increased up to 0.378±0.01 units (p <0.001) in 2 min after painful irritation and it decreased up to 0.113±0.02 units (p <0.001) in 30 min. Lysozyme activity was 0.260±0.01 units. Single-phase reaction was determined after acute painful irritation: increase of lysozyme activity after acute somatic pain up to 0,450±0,014 units (p <0.001). Lysozyme activity was 0.246±0.02 units in
blood plasma of old rats. It decreased up to 0.170±0.01 units (p <0.01) after painful irritation and it was 0.387±0.01 (p <0.001) in the end of the experiment. Conclusion: Response on pain irritation has differences in different groups. The common vector of response reaction after pain was the increase lysozyme activity in month of age rats, adult rats, rats after eye opening and old rats. Reaction of increasing lysozyme activity the most expressed in adult rats. The data are considered as a preventive readiness of lysozyme to answer on damage and infection.


Annals of the Russian academy of medical sciences. 2014;69(11-12):17-23
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CARDIOLOGY: CURRENT ISSUES
FEATURES OF STRUCTURAL AND FUNCTIONAL CHANGES OF THE MYOCARDIUM IN PATIENTS WITH CHRONIC VIRAL HEPATITIS
Radaeva E.V., Govorin A.V., Chistiakova M.V.

Abstract

Objective: Our aim was to evaluate the characteristics of structural and functional changes of the heart in patients with chronic viral hepatitis. Methods: The study included 123 patients — 17 subjects with aviremiey after antiviral therapy (group 1), 38 patients with laboratory inactive hepatitis (group 2), 68 patients with biochemical active hepatitis (group 3). All patients had standard echocardiography, Doppler sonography and tissue Doppler echocardiography. Results: Patients with chronic viral hepatitis were revealed to develop changes in the geometry of the left ventricle (increase in the wall thickness). Patients with active hepatitis had increase in the left atrium, the right ventricle and indexed left ventricular mass of the heart. Significant morphological changes were not confirmed statistically in patients after «therapy». Pulmonary hypertension was revealed in 19% of cases, mitral valve prolapse was confirmed in 48%, with the detection rates being not dependent on hepatitis activity. Abnormal left ventricular remodeling was identified in 45% of patients, subjects with active hepatitis developed it more often. Dysfunction relaxation of both right and left ventricles depended on the activity of the inflammatory process in the liver. The condition partially persisted after antiviral treatment. Conclusion:
Specifics of the structural and functional changes of the heart in patients with chronic viral hepatitis is the development of left ventricular hypertrophy and in the presence of laboratory activity hepatitis — relative dilatation of the right heart and ventricular diastolic dysfunction of the heart. Carrying out specific antiviral therapy has a beneficial effect on cardiac hemodynamics parameters. Method of tissue Doppler echocardiography was efficient in evaluation of early disorders of diastolic function in patients with chronic viral hepatitis.



Annals of the Russian academy of medical sciences. 2014;69(11-12):24-30
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PEDIATRICS: CURRENT ISSUES
TRENDS OF INFANT AND CHILD MORTALITY IN THE RUSSIAN FEDERATION IN THE PERIOD OF 1990–2012
Baranov A.A., Namazova-Baranova L.S., Al'bitskii V.Y., Terletskaya R.N.

Abstract

Objective: Dynamics and causes of infant and child mortality in the Russian Federation in post-Soviet period (1990–2012) under conditions of demographic policy implementation and healthcare system reforming are presented. Methods: Federal State Statistics Service's official statistics data (1990–2012) had been analyzed. The data was compared with similar rates of European Union countries. Results: It’s been revealed that infant mortality decreased (more than in 2 times) (from 17.4‰ to 8.6‰) through all its level indicators (early neonatal, neonatal, post-neonatal mortality) and due to almost all basic reasons (perinatal disorders, infectious diseases, respiratory diseases, congenital anomalies, accidents). Infant mortality rate in rural areas is higher (10.1‰ and 8.1‰), however, the gap between rates in rural regions and in cities is decreasing. In Russian Federation the infant mortality has regional distinctions, thus  Siberian and Far Eastern regions are the least advantaged areas. Mortality of children under 5 y.o. is declining (from 21.3‰ to 10.6‰), but its rate is still higher than in European Union countries (3.5‰). External factors occupy the top position as a death cause of infants and toddlers; the number of clinical cases with a diagnosis of malignant neoplasm increases. Conclusion: Thus, improving of the system of motherhood and childhood protection in the Russian Federation has resulted in significant reduction of infant and child mortality rate.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):31-38
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ASSESSMENT OF THE LIFE QUALITY IN CHILDREN WITH PHENYLKETONURIA
Bushueva T.V., Vinyarskaya I.V., Chernikov V.V., Borovik T.E., Kuzenkova L.M.

Abstract

Background: Phenylketonuria (PKU) — the most common inherited disorder of amino acid metabolism, identified in Russia by neonatal screening. The results of dietary treatment demonstrate a positive effect. However, the quality of PKU patients life remains unknown. Objective: The aim of the study was to assess the quality of PKU children life compared to their healthy peers, also depending on the timing of the treatment start and the patient's age. Methods: The study involved 64 pairs — PKU child and one of his parents. It was used the common questionnaire survey Pediatric Quality of Life Inventory (PedsQLtm4.0, Varni et al., USA, 2001) and the program SPSS v. 14.0 (US) for statistical processing of the results. Results: It was found the statistically significant (p <0.001) differences between PKU patients and healthy children in the physical, emotional, social and role functioning. The most pronounced differences were observed in the social (70 points vs 90 respectively) and role (57.5 vs 80 respectively) functioning. Maximum significant correlation (p <0.001) was installed between the social functioning of PKU patients and timing of the dietary treatment. Also the statistically significant relationship (p <0.05) was found between the role functioning and patient’s age and timing of the treatment. The assessment points of social and role functioning were higher (p <0.05) in the PKU patients subgroup with early treatment initiation. Conclusion: These results confirmed the need of early diagnostics of PKU and initiation of dietary treatment, as well as the organization of timely psychological support for parents of sick children.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):39-45
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CHRONIC HEPATITIS C IN CHILDREN: PROBLEMS AND PROSPECTS
Volynets G.V., Potapov A.S., Skvortsova T.A.

Abstract

The analysis of the problem of chronic hepatitis C (CHC) in children. The data on the incidence of primary CHC child population on the territory of the Russian Federation and abroad. The problems of diagnosis of HCV-infection. Conducted a review of the risk of infection, highlight the possible routes of transmission are shown peculiarities of HCV-infected children, shows the frequency of chronic process. The state of the problem at the moment and evaluated further promise in the treatment of chronic hepatitis C in children.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):46-53
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HISTORY CASE OF MULTIPLE HEPATIC ADENOMAS IN ADOLESCENT WITH SEVERE COURSE OF GLYCOGEN STORAGE DISEASE TYPE 1B
Surkov A.N., Namazova-Baranova L.S., Potapov A.S., Sevast'yanov K.V., Pushkov A.A., Nikitin A.G., Polyakova S.I., Ryazanov M.V., Kustova O.V., Barskii V.I., Stepanyan M.Y.

Abstract

We represented a case history of multiple hepatic adenomas in an adolescent with severe clinical course of glycogen storage disease type 1b (compound heterozygous mutations с.1042_1043delCT and с.817G>A in the SLC37A4). The patient was prescribed a raw cornstarch and hepatoprotectors
therapy, but he and his parents had low compliance to treatment. At the age of 13,5 years ultrasound investigation and computed tomography revealed multiple adenomas. Due to the severe condition of the patient it was impossible to perform focal hepatic biopsy. At present time the patient receives treatment focused on correction of metabolic disturbances, thereafter an applicability of exploratory puncture will be settled for the further patient surveillance. The modern data on causes and risk factors of hepatic adenomas in such patients, the possibility of their malignization, the algorithm of the follow-up and the methods of treatment are presented in the discussion.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):54-59
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CONFOCAL LASER ENDOMICROSCOPY OF GASTROINTESTINAL TRACT: HISTORY, PROBLEMS AND PERSPECTIVES IN CHILDREN
Shavrov A.A., Shavrov A.A., Kharitonova A.Y., Morozov D.A., Talaev A.G., Gaidarenko A.E., Kalashnikova N.A.

Abstract

In this review history, principles, technique and clinical applications of confocal laser endomicroscopy are briefly described. This technology allows to expand the diagnostic ability of traditional white light endoscopy and to assess effectiveness of therapeutic procedures in different gastrointestinal diseases. New experimental and clinical data in assessing small bowel barrier dysfunction as a predictor of relapse for inflammatory bowel disease is presented. Problems and perspectives regarding application of optical biopsy for gastrointestinal tract in pediatric practice are discussed.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):60-66
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ONCOLOGY: CURRENT ISSUES
PREDICTIVE VALUE OF HODGKIN’S LYMPHOMA TUMOR BURDEN IN PRESENT
Kuleva S.A., Karitskii A.P.

Abstract

Today approximately 70% of patients with Hodgkin lymphoma can be cured with the combined-modality therapy. Tumor burden, the importance of which was demonstrated at first 15 years ago, is a powerful prognostic factor. Data of literature of representations on predictive value of Hodgkin’s lymphoma tumor burden are shown in the article. The difficult immunological relations between tumor cells and reactive ones lead to development of the main symptoms. Nevertheless, the collective sign of tumor burden shows the greatest influence on survival and on probability of resistance, which relative risk can be predicted on this variable and treatment program. Patients with bulky disease need escalated therapy with high-dose chemotherapy. Integration into predictive models of the variable will change an expected contribution of clinical and laboratory parameters in the regression analyses constructed on patients with Hodgkin's lymphoma. Today the role of diagnostic functional methods, in particular a positron emission tomography, for metabolic active measurement which allows excluding a reactive component is considered.

Annals of the Russian academy of medical sciences. 2014;69(11-12):67-71
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ETHNIC ASPECTS OF HEREDITARY BREAST CANCER IN THE REGION OF SIBERIA
Cherdyntseva N.V., Pisareva L.F., Panferova E.V., Ivanova A.A., Malinovskaya E.A., Odintsova I.N., Doroshenko A.V., Gervas P.A., Slonimskaya E.M., Shivit-ool A.A., Dvornichenko V.V., Choizonov E.L.

Abstract

Background: Ethnic diversity of the population in the region of Siberia suggests the existence of different germline mutations in the BRCA1/2 genes associated with breast and ovarian cancer in different ethnic populations, but spectrum of these mutations has not been studied. Objective: Our aim was to evaluate the frequency of the most common mutations BRCA1 / 2 (BRCA1 5382insC, BRCA1 185delAG, BRCA1 4153delAG, BRCA1 T300G, BRCA2 6174delT) in women diagnosed with breast cancer among indigenous people and newcomers living in Siberia. Methods: We tested 1281 genomic DNA samples for the presence of BRCA1 5382insC mutation in patients diagnosed with breast cancer considering no family history. 72 patients having hereditary cancer signs were tested for the mutations BRCA1 185delAG, BRCA1 4153delAG, BRCA1 T300G, BRCA2 6174delT. Results: Out of 765 patients of Slavic ethnic group, 27 women (3.5%) were carriers of allele BRCA1 5382insC. The frequencies of mutations in patients with signs of hereditary cancer were: 8.3% in group of young patients (under 40 years), 20.0% in patients with bilateral cancer and 5.7% in patients with family history of breast or ovarian cancers. We tested 516 BC patients residing on the territory of the Buryat-Aginsky district, Republics of Tyva and Altai. Out of them, there were 197 patients among the indigenous population (buryats, tuvinians, altaians), and 319 patients among newcomers (Slavic ethnics). Mutations BRCA1 5382insC were detected only in women from Slavic ethnic groups. The frequency of BRCA1 5382insC mutation was 6% in the group where family history was excluded and 14% in the group of patients with characteristics of family cancer. Allele BRCA1 5382insC was not found in indigenous breast cancer patients, although 59 patients had signs of hereditary cancer. In women from Slavic ethnic group, the BRCA1 185delAG, BRCA1 4153delAG and BRCA1 T300G mutations were detected in 9.1% of cases and were not found in patients among the indigenous population. Conclusion: studies of mutations in the BRCA1 gene in breast cancer patients from Siberia confirmed data on the high frequency of «founder mutation» BRCA1 5382insC in Slavic population and indicate the advisability of further studies to identify the genes responsible for the occurrence of hereditary breast cancer in the indigenous population.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):72-79
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SHORT MESSAGES
THE EFFECT OF DIFFERENT TYPES OF SPORTS AND ATHLETES’ AGE ON THE PATHOLOGICAL CHANGES OF THE MUSCULOSKELETAL SYSTEM
Achkasov E.E., Puzin S.N., Litvinenko A.S., Kurshev V.V., Bezuglov E.N.

Abstract

Objective: Our aim was to determine the most common musculoskeletal diseases, depending on the type of sports and athletes’ age. Methods: The results of examination of 976 athletes aged 16 to 42 years (average age — 28,9±2,3) with musculoskeletal diseases were analyzed. Medical diagnostic procedures included clinical, laboratory, instrumental (radiography, magnetic resonance imaging, ultrasound) investigations and functional testing (goniometry, manual muscle testing). Results: Majority of patients were diagnosed to have diseases of the knee (17.9%) and ankle joints (11.3%), the heel bone (12.9%), Achilles tendon (10.2%), post-traumatic musculoskeletal diseases (16.2%), degenerative-dystrophic diseases of the spine (12.8%). In the young age group (16 to 20 years) post-traumatic disorders were most common. In the middle-age group (21 to 30 years) along with post-traumatic disorders diseases of the knee frequently occurred. For athletes over 30 years old, along with diseases of the knee spinal diseases were found to occur more than 2–3 times often compared with other age groups. Injuries which are more common for different types of sports were identified: acute traumas — competitive sports, diseases of the calcaneus — sports with running and jumping (athletics, volleyball, soccer), disease of ankle joints — sport with sharp change in movement direction (hockey, figure skating), disease of the knee — sports with high load of the knee joint (figure skating, gymnastics, volleyball, diseases of bones and joints of the upper extremity — tennis, disease of spine — weightlifting. Conclusion: pathological changes in the musculoskeletal system depend on the type of sports and the age of athletes. The combination of age and risk factors associated with type of sport increases the possibility of development of these diseases of the musculoskeletal system.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):80-83
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METABOLIC ADAPTATION RESOURCES OF ORGANISM TO STUDYING AT MEDICAL UNIVERSITY STUDENTS IN EUROPEAN NORTH
Ignat'eva S.N., Kubasov R.V.

Abstract

Background: A student studying is accompanied with psychoemotional stress that requires functional changes in metabolic systems. A blood leucocytes enzyme activity indexes that provides an adaptation are the indicators of energy metabolism. Objective: The aim of investigation is to determine the features and role of metabolic adaptive changes in the white blood cells of the students in European North during educational process. Methods: In the course of year, third course general practitioner faculty students of medical university were investigated seven times (before and after autumn semester, after winter examination period, after summer examination time and during a summer vacation). In blood leucocytes of all the examined patients indicators of enzymes activity of dehydrogenases were detected  — succinate dehydrogenase (SDG) and glutamate dehydrogenase (GDG), as well as hydrolytic enzymes ― acid phosphatase and alkaline phosphatase. Results: During the year different changes of blood leucocytes enzyme activity were detected depending on the intensity of training load ; a most higher SDG and GDG activity were detected in winter time, after examination period as well as after spring semester; an acid phosphatase occurred in the autumn semester but alkaline phosphatase increased in all examination times. Conclusion: An enzyme activity changes have a phase character and  are accompanied by a coherent, mutual interaction  that depends on educational process specifics and examinations. This changes lead to adequacy of adaptation response.

 

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):84-88
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RADIONUCLIDE IMAGING IN THE EVALUATION OF THE FUNCTIONAL STATE OF THE TRANSPLANTED KIDNEY IN THE POST-TRANSPLANT PERIOD
Kapishnikov A.V., Kolsanov A.V., Pyshkina Y.S.

Abstract

Objective: The aim of our clinical study was to evaluate the possibility of diagnosis of postrenal-transplantation complications in recipients using dynamic scintigraphy basing on temporary parameters standard zones of interest and medullary zone of renal transplantat comparing the results with the histological findings. Methods: We determined time of maximum and one-half maximal activity of radiopharmaceutical medication in renal transplantat, parenchyma and medullary zone the graft. According to pathological diagnosis, patients were categorized into three
groups: first — normals (n =32), second — acute rejection (n =43), third — chronic nephropathy (n =43). Results: In this study 118 patients aged 21–60 (38.4±9,8) years were included who underwent dynamic renal scintigraphy and biopsy renal transplantat. The time of maximum activity radiopharmaceuticals parenchyma the graft in patients in first group — 3.24±0.54 min, second — 6.61±3.28 min, third — 6.21±4.17 min (р <0,001). The time of maximum activity
radiopharmaceuticals medullary zone the graft in patients in first group — 3.95±0.95 min, second — 8.94±5.23 min (р <0,001), third — 7.29±4.16 min (р <0,01). The time of maximum activity radiopharmaceutical the whole graft in patients in first group — 3.87±0.62 min, second — 7.4±3.82
min (р <0,001), third — 8.03±4.28 min (р <0,01). The time one-half maximal activity radiopharmaceuticals parenchyma the graft in first group — 10.4±2.95 min, second — 37.09±3.89 min (р<0,001), third — 29.67±3.1 min (р<0,005). The time one-half maximal activity radiopharmaceuticals medullary zone the graft in first group — 11.71±5.93 min, second — 79.34±9.81 min (р <0,001), third — 29.67±3.95 min (р <0,005). The time one-half maximal activity radiopharmaceuticals the whole graft in first group — 12.31±3.91 min, second — 53.29±8.22 min, third — 52.71±7.86 min (р <0,001). Anderson–Bahadur distance: Т1/2
medullary zone the graft most significant between first and second groups patients (17.43), gives maximum index value at chronic nephropathy (-9.07), at differentiation between acute rejection and chronic nephropathy (8.48). Estimate of the area under the ROC indicate most informative time of maximum accumulation of the radiopharmaceutical of the whole graft (SRoc=0,907) in acute rejection and Tmax parenchyma the renal transplantat (SRoc=0,847) in patients with chronic nephropathy the graft. Sensitivity and specificity renal scintigraphy parameters of diagnosing on postrenal transplantation complications amounted 71.43–98.7% and 67.7–96.43% respectively. Conclusion: Renal scintigraphy is an additional test for early detection on postrenal transplantation complications and correct tactics conducting recipients. The parameters of kinetics of nephrotropic radiopharmaceuticals provide diagnosis of acute rejection and chronic nephropathy the graft. Inclusion of radionuclide diagnostics to monitor the state renal transplantat optimizes approach to biopsies graft.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):89-96
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EXPERIMENTAL MODEL OF OCULAR ISСHEMIC DISEASES
Kiseleva T.N., Chudin A.V.

Abstract

The review presents the most common methods of modeling of retinal ischemia in vitro (chemical ischemia with iodoacetic acid, incubation of the retinal pigment epithelium cells with oligomycin, deprivation of oxygen and glucose) and in vivo (a model with increased intraocular pressure, cerebral artery occlusion, chronic ligation of the carotid arteries, photocoagulation of the retinal vessels, occlusion of the central retinal artery, endothelin-1 administration). Modeling ischemic injury in rats is the most frequently used method in studies, because the blood supply of their eyes is similar to blood flow in the human eyes. Each method has its own advantages and disadvantages. Application of methods depends on the purpose of the experimental study. Currently model of ocular ischemic disease can be obtained easily by injecting vasoconstrictive drug endothelin-1. It is the most widely used method of high intraocular pressure induced ocular ischemic damage similar to glaucoma, occlusion of central retinal artery or ophthalmic artery in human. The development of experimental models of ocular ischemic diseases and detailed investigation of mechanisms of impairment of microcirculation are useful for improve the efficiency of diagnostic and treatment of ischemic diseases of retina and optic nerve.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):97-103
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CHANGES IN FUNCTIONAL ACTIVITY OF NEUTROPHILS IN PERIPHERAL BLOOD OF PATIENTS WITH RENAL CELL CANCER IN THE COURSE OF THE DISEASE
Kurtasova L.M., Shkapova E.A., Zukov R.A.

Abstract

Objective: Research purpose was to study phagocytic activity and a oxygen depended metabolism of blood neutrophils (NF) at patients with a renal cell carcinoma in dynamics — before operation and after surgical treatment. Methods: Patients with a locally invasive renal cell carcinoma (T3N0M0) were put under observation before surgical treatment (n =84) and in 10 days after a radical nephrectomy (n =54) at the age of 45–55 years. The 56 conditionally healthy donors combine into the control group. Indicators of functional activity, the spontaneous and induced lyuminol- and lyutsigenindependent chemiluminescence (CHL) NF of peripheral blood was studied. Results: During the period before operation time of an exit to a maximum of spontaneous and stimulated lyuminol-dependent HL is slowed down (p <0.004 and p <0.006 respectively); indicators of the area of lyutsigenin-dependent HL NF of blood concerning indicators of control group are increased (p <0.001 for spontaneous, p <0.004 for the reaction induced by lyutsigenin). In 10 days after surgical treatment the quantity of active ingestion rate lowered (p <0.017 in the test with S. epidermidis, p <0.036 for test with latex); time of an exit to a maximum of spontaneous and stimulated lyuminol-dependent remains increased (p <0.006 and p <0.008 respectively) in comparison with indicators of healthy donors. The amount of an index of activation of lyuminol-dependent as in comparison with control (p <0.037), and relative to the period before operation increases (p <0.048). The area of spontaneous lyutsigenin-dependent HL NF of blood relative to indicators of control group is still increased (p <0.011), decrease in this parameter in comparison with amount of group before operation is however registered (p <0.004). Conclusion: At patients with renal cell carcinoma in 10 days after surgical treatment of NF of blood are characterized by the strengthened production of high-energy oxidizers and the reduced phagocytic activity that testifies to a functional and metabolic imbalance.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):104-109
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PATHOPHYSIOLOGICAL ASPECTS OF WOUND HEALING IN NORMAL AND DIABETIC FOOT
Maksimova N.V., Lyundup A.V., Lyubimov R.O., Mel'nichenko G.A., Nikolenko V.N.

Abstract

The main cause of long-term healing of ulcers in patients with diabetic foot is considered to be direct mechanical damage when walking due to reduced sensitivity to due to neuropathy, hyperglycemia, infection and peripheral artery disease. These factors determine the standard approaches to the treatment of diabetic foot, which include: offloading, glycemic control, debridement of ulcers, antibiotic therapy and revascularization. Recently, however, disturbances in the healing process of the skin in diabetes recognized an additional factor affecting the timing of healing patients with diabetic foot. Improved understanding and correction of cellular, molecular and biochemical abnormalities in chronic wound in combination with standard of care for diabetic foot gives new hope to solve the problem of ulcer healing in diabetes.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):110-117
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TOPICAL ISSUES OF BIOLOGICAL SAFETY UNDER CURRENT CONDITIONS. PART 3. SCIENTIFIC PROVISION FOR THE NATIONAL REGULATION OF THE BIOLOGICAL SAFETY FRAMEWORK IN ITS BROAD INTERPRETATION
Smolenskii V.Y., Ezhlova E.B., Demina Y.V., Toporkov V.P., Toporkov A.V., Lyapin M.N., Kutyrev V.V.

Abstract

Consequent of investigation concerned with biological safety (BS) framework development in its broad interpretation, reflected in the Russian Federation State Acts, identified have been conceptual entity parameters of the up-to-date broad interpretation of BS, which have formed a part of the developed by the authors system for surveillance (prophylaxis, localization, indication, identification, and diagnostics) and control (prophylaxis, localization , and response/ elimination) over the emergency situations (ES) of biological (sanitary-epidemiological) character. The System functionality is activated through supplying the content with information data which are concerned with monitoring and control of specific internal and external threats in the sphere of BS provision fixed in the Supplement 2 of the IHR (2005), and with the previously characterized nomenclature of hazardous biological factors. The system is designed as a network-based research-and-practice tool for evaluation of the situation in the sphere of BS provision, as well as assessment of efficacy of management decision making as regards BS control and proper State policy implementation. Most of the system elements either directly or indirectly relate to the scope of activities conducted by Federal Service for Surveillance in the Sphere of Consumers Rights Protection and Human Welfare, being substantial argument for allocating coordination functions in the sphere of BS provision to this government agency and consistent with its function as the State Coordinator on IHR (2005). The data collected serve as materials to Draft Federal Law “Concerning biological safety provision of the population”.

Annals of the Russian academy of medical sciences. 2014;69(11-12):118-127
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THE COMBINED USE OF BISPHOSPHONATES AND STRONTIUM RANELATE WITH OSSEOSUBSTITUTING MATERIALS
Khlusov I.A., Vengerovskii A.I., Novitskii V.V.

Abstract

In review the possibility of biomaterials osseointegration improvement with help of bisphosphonates or strontium ranelate is discussed. For this purpose, they are added to hydroxyapatite used for implants coating, or are included as a component of bulk calcium phosphate materials. Strontium is employed as a compound of biodegradable metal alloys, also. Combined use of carrier (implant) with bisphosphonates or strontium ranelate promotes controlling local delivery of pharmaceutical molecules into lesion, enhances the therapy efficiency, and decreases a dose and systemic toxicity of the drugs. Bisphosphonates and strontium ranelate increase the mass, a count and thickness of bone trabeculas, improve the bone biomechanical properties in the place of implants fixation, and diminish the bone fracture risk. Main studies are devoted to pharmacologic mechanisms of implants osseointegration improvement. Bisphosphonates as isoprenoid lipids chemical analogues diminish by concurrent principle the
osteoclasts farnesyl pyrophosphate synthase activity and inhibit the prenylation. Unprenylated small GTPases don’t fasten onto osteoclasts membrane that weakens cellular resorptive activity and accelerates their apoptosis. Strontium ranelate enhances osteoblasts replicative activity and suppresses their apoptosis, also retards osteoclasts resorptive function and accelerates their apoptosis. Its effects are conditioned by activating Wnt-signaling pathway by means of calcium-sensing receptor and by changing the RANKL/RANK/OPG system.

 

Annals of the Russian academy of medical sciences. 2014;69(11-12):128-132
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