EDITORIAL
NTERDISCIPLINARY BASIC RESEARCH IN MEDICINE
Object of research: to explore the relationship of leptin level in blood serum with markers of systemic inflammation and spontaneous production of cytokines and reactive oxygen species by blood mononuclear leukocytes at metabolic syndrome.
Material and methods. We conducted a study of 50 patients with essential hypertension stage II in conjunction with the metabolic syndrome. Along with a complete clinical, laboratory and instrumental examination adopted in specialized cardiological clinic, were determined the concentration of markers of systemic inflammation and leptin in blood serum, as well as the relative abundance of the surface markers CD4+-, CD8+-lymphocytes and CD36+-monocytes, the level of spontaneous production of proand antiinflammatory cytokines and active oxygen species by blood mononuclear leukocytes.
Results. It was found that patients with essential hypertension stage II with the MS having hyperleptinemia statistically significantly differ both as greater activity of systemic inflammation, and have a greater percentage of CD4+-lymphocytes and a higher level of spontaneous production of blood mononuclear leukocytes a number of proinflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α, MCP-1) and reactive oxygen species.
The analysis of radiologic signs of small size breast cancer in patients with fibrocystic disease has been carried out.
The conventional approach to the analysis of mammograms of these patients based on the detection of primary, secondary and indirect cancer symptoms has been found to have insufficient effect.
The relationship between mammographic findings and primary tumor size, character and concomitant disease intensity has been proved.
The data obtained allow us to arrange the diagnostic process and management of patients with breast lesions.
Carbon monoxide CO, as well as nitric oxide and hydrogen sulfide, make up the family of labile biological mediators termed gasotransmitters. We hypothesized that CO may be involved in the mechanisms of regulation electrical and contractile properties of smooth muscles.
The effects of carbon monoxide donor CORM II (tricarbonyldichlororuthenium(II)-dimer) on the electrical and contractile activities of smooth muscles of the guinea pig ureter were studied by the method of the double sucrose bridge. This method allows to register simultaneously the parameters of the action potential (AP) and the contraction of smooth muscle cells (SMCs), caused by an electrical stimulus.
CORM II in a concentration of 10 mmol has reduced the amplitude of contractions SMCs to (86.5 ± 9.7)% (n = 6, p < 0.05), the amplitude of the AP to (88.9 ± 4.2)% (n = 6, p < 0.05) and the duration of the plateau of the AP to (91.7 ± 6.0)% (n = 6, p < 0.05). On the background of the action of biologically active substances (phenylephrine, 10 µmol or histamine, 10 µmol), these effects of CORM II amplified. The inhibitory action of СORM II on the parameters of the contractile and electrical activities of the smooth muscles of guinea pig ureter has been decreased by blocking potassium channels in membrane of SMCs by tetraethylammonium chloride (TEA) оr inhibition of soluble guanylate cyclase (ODQ [1H-[1,2,4]-oxadiazolo[4,3-a]quinoxalin-l-one]). On the background of TEA (5 mmol), a donor of CO (10 mmol) caused a reduction the amplitude of contraction SMCs to (87.0 ± 10.8)% (n = 6, p < 0.05), the amplitude of the AP to (91.7 ± 6.4)% (n = 6, p < 0.05) and the duration of the plateau of the AP to (93.4 ± 7.5)% (n = 6, p < 0.05). After the pretreatment of ODQ (1 µmol) adding CORM II (10 mmol) in solution has resulted to augment of the amplitude of contraction ureteral smooth muscle strips to (90.9 ± 4.2)% (n = 6, p < 0.05), the amplitude of the AP to (97.2 ± 10.3)% (n = 6, p < 0.05) and the duration of the plateau of the AP to and (99.7 ± 10.0)% (n = 6, p < 0.05).
Thus, can be argued the inhibitory effect of carbon monoxide on the electrical and contractile activities of the guinea pig ureter SMCs is due to changes in the ionic conductivity of the membranes, above all with increasing the potassium conductance or activation of soluble guanylate cyclase.
Introduction: The leading mechanisms and causes of severe therapy resistant asthma are poorly understood. The aim of this study was to define global patterns of gene expression in adults with severe therapy-resistant asthma in dynamic during treatment period.
Methods: Performed 24-week prospective interventional study in parallel groups. Severe asthma patients was aposterior divided at therapy sensitive and resistant patients according to ATS criteria. Global transcriptome profile was characterized using the Affymetrix HuGene ST1.0 chip. Cluster analysis was performed.
Results and conclusion: According to our data several mechanisms of therapy resistance may be considered: increased levels of nitric oxide and beta2-agonists nitration, dysregulation of endogenous steroids secretion and involvement in the pathogenesis of Staphylococcus aureus. Absence of suppression of gene expression KEGG-pathway “asthma" may reflect the low efficiency or long period of anti-inflammatory therapy effect realization.
Objective: study sesquiterpene lactones grosshemin and grossmisin lipid-lowering properties on the model of acute hyperlipidemia induced by ethanol in rats.
Materials and methods. Rats during 7 days injected into the stomach grosshemin and grossmisin in a dose 10 mg/kg or reference drug nicotinic acid in a dose 25 mg/kg. Hyperlipidemia caused by single introduction of ethanol into the stomach in a dose 5 g/kg. In blood serum of tail vein measured the triacylglycerols, total cholesterol, high density and low density lipoproteins cholesterol, also the level of free fatty acids. Calculated the ratio of high density lipoproteins cholesterol to the amount of low density lipoproteins cholesterol and the index of atherogenicity.
Results. A single dose of ethanol increased serum level of triacylglycerols in 1.9 times, free fatty acids – in 3.2 times, low density lipoproteins – on 44% in comparison with the intact animals indices. It shows the development of acute hyperlipidemia. Serum total cholesterol, high density lipoproteins cholesterol and the index of atherogenicity were not changed. Course sesquiterpene lactones grosshemin and grossmisin introduction against the background of acute hyperlipidemia was accompanied by a decrease in the serum of triacylglycerols levels respectively by 19.8% and 34.1%. Nicotinic acid lowered the content of triacylglycerols by 42.4%. Grosshemin and nicotinic acid reduced the increased level of free fatty acids in the blood serum by 60.7–67.9%. Grossmisin and nicotinic acid decreased by 14.6–17.2% of total cholesterol in the blood serum. In acute hyperlipidemia grosshemin and grossmisin reduced low density lipoproteins cholesterol by 17.6% and 20%, respectively, nicotinic acid – by 15.7%. Both of sesquiterpene lactone and nicotinic acid did not modify the content of high density lipoproteins cholesterol. When introduction grosshemin, grossmisin and nicotinic acid ratio of high density lipoproteins cholesterol to the amount of low density lipoproteins cholesterol significantly increased by 42.8%, 38,6% and 22.1% respectively.
Conclusion. Sesquiterpene lactones grosshemin and grossmisin posses hypolipidemic effect in acute experimental hyperlipidemia caused by the ethanol introduction. Lactones normalize many indices of lipid metabolism, which can be caused by different biochemical targets of these molecules. Lactones, as nicotinic acid, in the model of acute hyperlipidemia decrease in blood serum triacylglycerols, total cholesterol, and low density lipoproteins cholesterol content. Grosshemin and nicotinic acid also reduce the free fatty acids level.
This paper describes study of larynx microflora in patients with acute laryngtis and exacerbations of chronic laryngitis. Therapeutic algorithm based on bacteriologic examination data was developed reduce. New algorithm helps reduce sickness terms and to decrease prevalence of desease.
123 patients of age from 18 to 60 were under observation: 43 patients with acute laryngitis and 80 patients with exacerbation of chronic laryngitis. 22 patients with acute laryngitis and 58 patients with exacerbation of chronic laryngitis underwent etiotropic treatment with antibiotics. The group of comparison with acute laryngitis (21 patients) and chronic laryngitis (22 patients) received treatment according to the conventional scheme.
Bacteriologic examination of larynx mucous, clinical study and functional voice test (time of maximum vowels phonation) before and after treatment were carried out.
As a result of the research it was established that the most common causative agent of acute and chronic inflammatory larynx diseases is S. aureus as a mono culture or combined with other bacterial associations (S. аnhemolyticus, Str. viridans etc.).
After the end of antibacterial therapy we found symptoms as hoarseness, irritation, dry laryngopharynx, hyperemia and swelling of larynx mucous reduced eather in new treatment group than controlled group. Time of maximum vowels phonation (in seconds) also increased significantly.
Sickness terms after prescription of new treatment was shorter than in comparison groups: (10.9 ± 7.9) days for acute laryngitis and (12.6 ± 7.3) days for chronic laryngitis respectively. Health index was 20.8 and 19.5% respectively.
INNOVATIVE MEDICAL TECHNOLOGIES
In order to evaluate the possibilities of MRI in detection of proarrhytmogenic areas of myocardium we did compare directly and quantitatively the local myocardial uptake of paramagnetics to the results of electrophysiologic study of myocardium in twenty-two patients with recent transmural myocardial infarction and frequent ventricular extrasystoles verified by ECG studies.
Topic quantitative study of myocardial electric potential has been carried out using Carto XP system (by Biosense Webster).
By analysis of the images the measurement of Index of transmurality (IT) for the contrast uptake was calculated as ratio of thickness of paramagnetic uptake to overall thickness of myocardium in a specific segment.
The the electrophysiologic and MRI data were analyzed topically as segment vs segment and the significant tendency was revealed with simultaneous grow of pro-arrhythmogenic activity and value of IT. In other words, as bigger the IT increases, as arrhythmogenic the lectrical activity becomes. The best border value of IT that provided separation of electrically normal segments from proarrhythmogenic ones was the IT = 0.3.
Therefore we conclude the contrast-enhanced MRI of myocardium deliver additional information on risk of arrhythmias, not only the detection of myocardial damage itself.
The aim of this study was assessment of cardiac sympathetic activity in patients with atrial fibrillation by planar scintigraphy with 123I-metaIodbenzilguanidine (123I-MIBG).
Material and Methods. The study included 28 (average age (57.4 ± 11.6) years) patients with suspected coronary artery disease. All patients to divide 3 groups: 13 patients (group 1) with paroxysmal AF (PAF),
6 patients (group 2) with long-standing persistent AF (LSPAF) and 10 patients with no signs of AF (group 3).
Planar imaging was performed to study initial (imaging started 20 minutes after MIBG injection 148 MBq 123I-MIBG) and delayed (imaging started 4 hours after 123I-MIBG injection). For the anterior planar 123I-MIBG images, regions of interest were constructed for the heart and upper mediastinum, and the heart-mediastinal ratio (HMR).
Results. The delayed HMR in patients with PAF and LSPAF was significantly lower compared that in patients third group (1.59 ± 0.16, 1.54 ± 0.17 and 1.82 ± 0.11 respectively, p < 0.05). The washout rate of 123I-MIBG in patients with PAF and LSPAF was significantly highest compared that in patients with no signs of AF (33.4 ± 17.5, 29 ± 11.7 and 17.2 ± 9.6 respectively, p < 0.05). In assessment of regional sympathetic activity in patients with LSPAF defect accumulation 123I-MIBG in both the early and delayed scintigrams was significantly higher compared with groups of patients with PAF and without AF.
Results of this study indicated, that the patients with atrial fibrillation has of regional LV myocardial changes, according with 123I-MIBG imaging. More sympathetic innervation abnormality was observed in patients with long-standing persistent AF.
For the treatment of calculouscholecystitis in patients with high-risk surgery in the treatment of choledocholithiasis in an effort to preserve the sphincter apparatus major duodenal papilla are encouraged to use the contact litholysis gallstones saxifragant mixture of octanoic acid – glycerol in a ratio of 1 : 1.
The possibility of dissolution of stones in experiments in vitro (n = 51) and in vivo (n = 35), confirmed the low toxicity and high efficiency of the proposed technique. In vitro experiments, for more convenient evaluation was introduced conditional coefficient (K) that reflects the time lithodialysis in minutes per 1 mg of the stone weight. In experiments in vitro: K' = 5.76 (n = 51). It is noted that in the group of stones with low mineralization using saxifragant mixture K' = 4.50 (n = 15), with an average K' = 5.76 (n = 17), high K' = 6.88 (n = 19).
In an in vivo experiment used 35 sexually mature rabbits after modeling cholelithiasischolecystitis was made through the introduction of a mixture of saxifragant rate of 0.2 ml/kg body weight once a day. Lowmineralized stones disappeared in all cases (after the double administration) medium mineralizedwhen administered for 3 days or more, the highly mineralized 4 – day of treatment. After treatment, histologically and biochemically, were found pronounced toxic effects of the drug.
The clinic is possible to impose mikroholetsistostomy under ultrasound gui dance, irrigation lumen of the gall bladder, treatment of acute inflammation, followed by solvent solubility and control of stones with ultrasound studies, or using fistuloholangiografiyu. When choledocholithiasis, especially when residual common bile duct stones in an effort to preserve the sphincter apparatus ma jor duodenal papilla, possibly through the introduction of a mixture of saxifragant hepaticocholedochus established percutaneously transhepatic under ultrasound guidance, either through drainage nazobi liarny established endoscopically through major duodenal papilla. The advantages of this method compared to peers is less toxic solvent, speed lysing effect, the efficiency of the process calculi with different composition (cholesterol and pigment). Compared with the traditional methods of trea tment of gallstone disease differs minimally invasive and thus significantly reduces the risk of intra -and postoperative complications, both local and general, and significantly shorten the treatment of patients and their stay in hospital.
Aim: to determine the possibility of radionuclide methods in the identification of "sentinel" lymph node (SLN) in larynx and laryngopharynx cancer patients.
Material and methods: 17 patients with larynx and laryngopharynx cancer were included in research. In all patients for SLN visualization nanocolloid radiopharmaceutical was injection around tumor into mucous coat with the subsequent SPECT and radioguided study.
Results: Sensitivity and specificity of SPECT and radioguided study for SLN identification were 100%. We found 22 SLN in 17 patients (from 1 to 2 per patient, on average 1.3). Most often SLN were located in the III level of a neck (lymph nodes around of carotid arteries) – 12 SLN (54.5%) and IIA level (under lower jaw lymph nodes) – 6 (27.2%). One SLN (4.5%) was localized in IV level and 3 nodes (13.6%) in VI level. In 2 patients (11.8%) metastasis in SLN were found. In these patients within 2 years cancer progressing was revealed. Fifteen patients (88.2%) had no metastatic in SLN and had no progressing of a cancer.
Conclusions: Sensitivity and specificity of SPECT and radioguided study for SLN identification are 100%. In patients with metastatic SLN radical surgery with lymph node dissection is helpful.
LITERATURE REVIEW
HUMANITARIAN PROBLEMS OF BIOLOGY AND MEDICINE
МОЛОДЫЕ ИССЛЕДОВАТЕЛИ – МЕДИЦИНЕ
JUBILEES
ISSN 1819-3684 (Online)