Vol 94, No 5 (2013)

Theoretical and clinical medicine
Brachial artery vascular wall condition in patients with chronic obstructive pulmonary disease
Chudinova L.N.
Abstract
Aim. To study the structural and biomechanical characteristics of brachial artery in subjects with chronic obstructive pulmonary disease of varying severity and to compare the ultrasonographic data with the data of subjects of comparable age without signs of pulmonary disease. Methods. 109 patients with chronic obstructive pulmonary disease of varying severity aged 55-75 years and 31 patients of comparison group without any obstructive pulmonary diseases, but having concomitant arterial hypertension not exceeding 1st degree, were examined. All patients underwent a clinical interview, a threefold blood pressure measurement with a three-minute interval, the respiratory function study by spirometry, and ultrasonography of the right brachial artery. Patients with chronic obstructive pulmonary disease were subdivided to two groups according to the results of spirometry following administration of a bronchodilator based on the forced expiratory volume in one second (FEV 1) percentage to expected values. 55 patients with FEV 1 over 50% of expected values were pooled to the first group. The second group consisted of 54 patients with FEV 1 of 50% of expected values and lower. All groups were matched for sex, age and blood pressure level. Results. A reduction of brachial artery intima and adventitial layers thickness was found in patients with chronic obstructive pulmonary disease. The vascular wall in those subjects was prone to stretching, had decreased elasticity and increased tensility. In addition, there was an evidence of smooth muscular layer tone decrease in the brachial artery wall. Conclusion. In patients with chronic obstructive pulmonary disease aged 55-75 years, regardless of the severity of the disease, initial biomechanical and later structural and anatomical changes of the brachial artery associated with normal blood pressure, caused by chronic hypoxia were registered.
Kazan medical journal. 2013;94(5):593-596
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Psychological reserves of patients with laryngeal cancer
Moiseeva K.S.
Abstract
Aim. To reveal the psychological features of the patients, suffering from laryngeal cancer depending of surgical treatment type and extent. Methods. 109 patients of the clinical oncological hospital were included. The first group included 88 patients who underwent surgery: larynx resection - 35 patients, laryngectomy - 40 patients, and 13 patients in whom voice rehabilitation by imposing a shunt between a trachea and a gullet and vocal prosthesis introduction were performed. The second group included patients of radiological department who have refused surgery (21 patients) and were receiving radical gamma-knife radiotherapy. The psychological techniques were applied to assess the types of reaction to illness and intensity of psychopathological symptoms. Results. The psychological traits of patients in whom a tracheaesophagal shunt was formed, can describe them as socially adapted, patient with low anxiety level. Due to vocal prosthesis they can communicate, that is resulted in features of their behavior. Among compared groups, there were statistically significant differences in the extent of «projection» psychological protection mechanism and the degree of phobic disorders. Conclusion. It is necessary to create a rehabilitation complex for psychological rehabilitation of patients with laryngeal cancer. Further studies will help to understand, why they refuse surgery and to help them to complete a correct apprehension of illness basing on true data about their disease.
Kazan medical journal. 2013;94(5):597-599
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Blood ammonia level in chronic liver disease: clinical and pathogenetic importance
Akhramovich A.P., Sovalkin V.I.
Abstract
Aim. To evaluate blood ammonia concentration in patients with chronic liver diseases. Methods. 87 patients with chronic liver disease were examined. Ammonia concentration was determined using the enzymatic test. Results. Ammonia concentrations ranged from 18.16 to 118.36 μmol/l (median 43.7 μmol/l). Depending on blood ammonia level, 2 groups of patients were identified: with blood ammonia level below (first group) and above the median level (second group). The first group included 35 (79.5%) patients with liver cirrhosis and 9 (20.5%) patients with chronic hepatitis, the numbers were similar in the second group: 36 (83.7%) and 7 (26.3%) patients correspondingly. Signs of portal gastropathy were identified in 25 (58.1%) and 26 (60.5%) patients correspondingly, while Helicobacter pylori infection was found in 5 (21.7%) and 8 (31.8%) patients with blood ammonia level below and above the median level correspondingly. Mean ammonia concentration in patients with liver cirrhosis and chronic hepatitis, with and without portal gastropathy, with mild and severe gastropathy did not differ significantly. Conclusion. Ammonia blood concentration can not reliably indicate liver failure, hepatic encephalopathy development and stage, portal hypertension and collateral development as well as predict gastric lesions.
Kazan medical journal. 2013;94(5):600-604
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Systemic manifestations in different stages of chronic obstructive pulmonary disease
Lapteva E.A., Lapteva I.M., Kharevich O.N.
Abstract
Aim. To reveal the systemic manifestations of chronic obstructive pulmonary disease and to match them with respiratory function parameters and extrapulmonary manifestations as the disease progresses. Methods. 160 patients were examined (128 patients with different stages of chronic obstructive pulmonary disease - the study group, and 32 healthy volunteers - the control group). Clinical examination, serum cytokine concentration measurement, lung function tests, airway resistance and lung volumes evaluation, assessment of hemodynamic parameters, bone mineral density assessment were conducted. Correlations between listed parameters were estimated. Results. It was found that the activation of systemic inflammation occurs at the early stages of the disease with the further increase as it progresses, as was shown by the increase of interleukin-6, interleukin-8, tumor necrosis factor alpha (TNF-α), C-reactive protein levels in the study group compared to the control. The relation between spirometry parameters and inflammatory markers confirmed the role of systemic inflammation in chronic obstructive pulmonary disease progression and cardiovascular complications development. A correlation between the C-reactive protein level and forced expiratory volume at 1st second (FEV 1), as well as between TNF-α level and FEV 1, TNF-α level and lung vital capacity was found. The study also confirmed the role of lung hyperinflation in pulmonary hypertension and chronic cor pulmonale occurrence and progression: mean pulmonary arterial pressure correlated with residual volume to total lung capacity ratio in patients with FEV 1 >50% and in patients with FEV 1 <50%. Significant correlations between lung function and parameters of pulmonary hemodynamics (FEV 1 with right ventricular end-diastolic dimension) were revealed. Correlations between femoral neck bone mineral density and residual lung volume and diffusing lung capacity confirmed the role of progressive emphysema and hypoxia in the pathogenesis of osteoporosis in patients with chronic obstructive pulmonary disease. Conclusion. Correlations between the severity of airway obstruction and systemic manifestations of chronic obstructive pulmonary disease were revealed.
Kazan medical journal. 2013;94(5):605-609
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Differential treatment strategy in patients with different clinical phenotypes of chronic obstructive pulmonary disease
Lapteva E.A.
Abstract
Aim. To optimize the treatment in patients with chronic obstructive pulmonary disease in primary care. Methods. The effectiveness of different strategies of long-term control treatment in 245 patients with chronic obstructive pulmonary disease depending on clinical phenotypes of the disease was evaluated. Three groups of patients were formed: patients from the 1 st group (70 patients, 33 - with predominant emphysema phenotype, 37 - with predominant bronchitis phenotype) were using long-acting anticholinergics, patients from the 2 nd group (110 patients, 52 - with predominant emphysema phenotype, 58 - with predominant bronchitis phenotype) - long-acting anticholinergics and inhaled corticosteroids, and patients from the 3 rd group (65 patients, 28 - with predominant emphysema phenotype, 37 - with predominant bronchitis phenotype) - long-acting anticholinergics together with inhaled corticosteroids and long-acting beta 2-agonists. The respiratory function, diffusing lung capacity and gas exchange parameters were assessed after 12 months of long-term control treatment. Results. The 2nd treatment strategy was more effective in patients with bronchitis phenotype, confirmed by the increase of forced expiratory volume at 1st second (FEV 1) value from 1.12±1.04 to 1.90±1.05 (р <0.05), and partial oxygen pressure (р аО 2) increase from 53.72±6.28 to 69.56±6.83 mmHg, as well as partial carbon dioxide pressure (р аCО 2) decrease from 55.71±8.34 to 52.34±8.16 mmHg. No significant changes in patients with emphysema phenotype were observed. The treatment strategy 3 was the most effective in patients with emphysema phenotype which was demonstrated by the increase of FEV 1 from 1.18±0.03 to 1.47±0.03, р аО 2 from 66.43±3.79 to 78.48±5.78 mmHg (р <0.05), diffusion capacity of carbon monoxide to alveolar volume ratio (DLCO/Va) increase from 35.32±11.34 to 44.12±12.2 (р <0.05) and decrease of р аО 2 from 50.21±3.68 to 43.43±5.47 mmHg. No significant improvement of gas exchange parameters in patients with bronchitis phenotype was registered. The treatment strategy 1 had no significant effect on respiratory function parameters. Conclusion. The differential strategies of long-term control treatment should be used depending on clinical phenotypes to optimize the treatment of chronic obstructive pulmonary disease.
Kazan medical journal. 2013;94(5):610-614
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Experimental medicine
Adrenal gland pathology in rats after acute postnatal hypoxia
Gubina-Vakulik G.I., Andreev A.V., Kolousova N.G.
Abstract
Aim. To study the histological changes in the adrenal glands of rats with acute postnatal hypoxia and «structural trace» in the adrenal glands during the first month of life. Methods. Wistar rats were used as experimental animals. After calving, the newborn rats (main group, 20 newborn rats, progeny of 5 female rats) were placed in the bell-pressure chamber (simulating altitude of 3.500 meters with an atmospheric pressure of 493 mm Hg) for 5 min. Rats were withdrawn from the experiment by decapitation at the first day (1 hour after the acute postnatal hypoxia modeling, 7 rats), 7 days after (7 rats) and 35 days after (6 rats) the experiment. The same number of intact rats of the control group were examined at the same timepoints. The adrenal glands of rats were examined morphologically using histological, histochemical, immunohistochemical and morphometric methods. Results. It was found that a short episode of mild short hypoxia just after the birth leads to the development of specific adaptive changes in adrenal glands: cortical hyperplasia, increased morpho-functional activity of endocrinocytes in the medullar substance associated with extensive apoptosis, decreasing of morpho-functional activity of endocrinocytes of the glomerular zone and fetal cortex. Cellular regeneration of spongiocytes was observed not only in the cambium layer, but also in the fascicular zone, which presumes not only physiological, but also reparative regeneration. Regeneration of medullar cells, seemingly, only occurs during the first few days after birth by migration of sympathogonia from outside of the adrenal gland to its center. At days 14 th and 35 th, despite the same conditions, histological signs of active functioning of the cortical fascicular zone and medullar substance preserved in animals of the main group compared with the controls. Conclusion. Results of the study prove the need for clinical studies of the adrenal function correction in newborns undergoing postnatal and intranatal acute hypoxia, as well as of consequences for the adrenal gland morpho-functional state after birth for such cases.
Kazan medical journal. 2013;94(5):615-621
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Mitochondrial oxidation in the internal organs of rats with cranial injury and diabetes mellitus
Meretskyy V.M.
Abstract
Aim. To study the relation between the processes of mitochondrial oxidation and the intensity of lipid peroxidation, pulmonary and cardiac proteins oxidative modification at cranial injury, diabetes mellitus and at both. Methods. Experiments were carried out on 100 male white rats distributed to the following groups: the first group (n=10) - control group consisted of 10 intact animals, the second group (n=40) - rats with simulated cranial injury, the third group (n=10) - rats with experimental diabetes mellitus, the fourth group (n=40) - rats with simulated cranial injury and experimental diabetes mellitus. Experimental diabetes was induced by a single intraperitoneal injection of streptozotocin solution. Animals were withdrawn from the experiment at 3, 24 hours, 5 and 14 days after the cranial injury. Cardiac and pulmonary energy supply was estimated by the activity of succinate dehydrogenase, cytochrome oxidase and hydrogen potassium ATPase, as well as by the level of adenine nucleotides. Intensity of free-radical protein and lipid peroxidation was assessed by measuring the levels of neutral and base aldehyde and ketone derivatives and active products reacting with thiobarbituric acid. Results. Decrease of succinate dehydrogenase, cytochrome oxidase activity, a significant increase of hydrogen potassium ATPase activity in heart and lungs mitochondria was observed in rats with cranial injury, diabetes mellitus and especially with both conditions. Adenosine triphosphate tissue reserves have significantly decreased, while adenosine diphosphate and monophosphate levels increased, lipid peroxidation and protein oxidation processes activated. Conclusion. In rats with cranial injury associated with diabetes mellitus, lipid and protein peroxidation intensity parameters, the intensity of oxidative stress and the levels of macroergic substanses were significantly worse compared to the same parameters in the injured animals with normal blood glucose level.
Kazan medical journal. 2013;94(5):621-627
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Hepatoprotective activity of a new germanium-organic biologically active substance (medgerm) in experimental hepatitis
Tymchyshin O.L.
Abstract
Aim. To study of the influence of new germanium-organic biologically active substance (medgerm) on lipid peroxidation and antioxidant system in rats with galactosamin-induced acute hepatitis. Methods. The experiments were carried out on Wistar male rats. Acute toxic hepatitis in rats was induced by intraperitoneal injection of D-galactosamine. Experimental animals were divided into 4 groups: first group (n=10) - intact animals that received 0.9% sodium chloride solution intraperitoneal injections throughout the observation period (control group); second group (n=40) - animals that received only D-galactosamine; third group (n=40) - rats that received medgerm intraperitoneal injections 7 days before and 7 days after the administration of D-galactosamine. The dose and administration regimen of medgerm were pre-defined. The fourth group (n=40) included rats that received Essentiale® N in the same mode as a comparator drug. Determination of thiobarbituric acid reactants, reduced glutathione levels in serum and liver homogenate supernatant, as well as superoxide dismutase and catalase activities were carried out in 1, 3, 5 and 7 days after the administration of liver toxins. Results. Medgerm has a significant effect on pro- and antioxidant homeostasis in acute toxic galactosamine-induced hepatitis. It effectively prevented the generation and accumulation of lipid peroxidation end products and preserved the activity of nonenzymatic and enzymatic antioxidant system parts. In animals treated with medgerm, studied parameters restored to reach the baseline level faster than in rats with galactosamine-induced hepatitis that were not treated with medgerm. Conclusion. The findings suggest that medgerm has the antioxidant activity and a membrane-mediated action in acute toxic hepatitis.
Kazan medical journal. 2013;94(5):628-632
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Reviews
Assessment of the severity of acute destructive pancreatitis for proper treatment selection
Valeev A.A.
Abstract
The review covers the most common integrated scales used for the assessment of severity of acute destructive pancreatitis. The use of those scales in the surgical in-patient department is discussed. Different views of Russian and foreign pancreatologists on the use of integrated scales to predict the disease outcome according to various criteria (clinical, laboratory, and special examination methods) are presented. Because of the acute pancreatitis morphological forms variety at admission for urgent surgery, there is a need for a comprehensive assessment of the disease severity in such patients. First stage of assessment is based on clinical data obtained at admission; correlation with systemic organ failure is also taken into account. This approach helps to distinguish mild, moderate and severe clinical course of disease. The use of multiple integral scales used for clinical assessment, with the number of possible options exceeding 20, is widely applied when the patient is admitted. The surgeon’s selection of a scale for assessment of the disease severity depends on the available equipment and the time for evaluation. Currently, the multi-parameter prognostic scales Ranson (1972), APACHE II (Acute Physiology And Chronic Health Evaluation, 1990), Glasgow-Imrie (1984), SAPS (Simplified acute physiology score, 1984), MODS (Multiple Organ Dysfunction Score, 1995), SOFA (Sepsis-related Organ Failure. 1996) are considered to be most objective. The use of these scales allows improving the prediction of outcome and necrotic complications by several times.
Kazan medical journal. 2013;94(5):633-636
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Healthcare mangement
Features of elderly urban population morbidity seeking for medical aid in out-patient clinics and polyclinics in Kazan
Akhunova E.R., Abrosimova M.Y.
Abstract
Aim. To assess the morbidity of elderly patients according to 3-year data of patient’s visits to out-patient clinics and polyclinics in Kazan. Methods. 250 patients’ charts were randomly picked at out-patient clinics and polyclinics in Kazan, containing data about diseases, forcing to seek for medical care from 2008 to 2010. Logical and system analysis, statistical grouping, a comparison method were applied. Results. The morbidity rate in elderly people according to the 3-year data was 7332.0 by 1000. Thus, every elderly patient had visited a doctor 2.4 times a year on average. The number of consultations with exacerbation of chronic diseases was 3.7 times more frequent compared to acute diseases. Most frequent reasons for seeking medical advice were cardiovascular diseases, with urogenital diseases on the second place and gastrointestinal diseases on the third place. Respiratory diseases and neoplasms were on the fourth and fifth places, respectively. Studying the number of visits depending on employment showed that it was significantly lower in employed elderly patients, and higher in employed females and unemployed males. Conclusion. The change of approaches to the management of elderly out-patients is needed, considering not only gender and sex differences, but also employment.
Kazan medical journal. 2013;94(5):637-640
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Assistance to the practicing physician
Ultrasonic diagnostics of Hirschsprung’s disease in adults
Shakurov A.F., Karpukhin O.Y., Yusupova A.F., Savushkina N.Y.
Abstract
Aim. To study the possibilities of hydrosonography for the differential diagnosis of Hirschsprung’s disease. Methods. The results of the examination of five patients with histologically confirmed diagnosis of Hirschsprung’s disease, 19 patients with slow transit constipation and 10 healthy volunteers are presented. Rectal ultrasonography was performed after retrograde colon filling with saline. Rectal lumen width, thickness and structure of the rectal mucosa and muscular layer were evaluated. The place of transition of rectal ampoule into the anal canal was thoroughly examined to determine rectal anal inhibitory reflex. Results. The following ultrasonic signs of Hirschsprung’s disease were identified: rectal wall thickening up to 6±0,7 mm due to muscular layer hypertrophy, hyperechoic mucosa, rectal lumen widening up to 60±5 mm. A high predictive value of ultrasonography for diagnosis of rectal anal inhibitory reflex absence in Hirschsprung’s disease (sensitivity 100%, specificity 96.7%, accuracy 97.1%). Advantages of the examination are obviousness and technical simplicity. With no introduction of a balloon, electrodes or ultrasonic detector into the rectal lumen, the results of examination can hardly be biased or miscomprehended. Conclusion. Hydrosonography might be used in diagnosis of Hirschsprung’s disease, this method facilitates the differential diagnosis of Hirschsprung’s disease and other forms of chronic constipation and contributes to the correct choice of treatment strategy.
Kazan medical journal. 2013;94(5):641-644
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Experience of drug therapy in hypertrophic cardiomyopathy
Shaposhnik I.I., Bogdanov D.V.
Abstract
Aim. To assess the impact of drug therapy on the clinical course of hypertrophic cardiomyopathy in long term. Methods. 90 patients with hypertrophic cardiomyopathy (males - 55, females - 35, mean age 42,0±1,52 years) were observed for a long period of time. Non-obstructive form of the disease was diagnosed in 72 (80%) patients, obstructive - in 18 (20%) patients. Average follow-up duration was 15,0±0,73 years. Drug therapy was received by 54 patients, 21 patients were treated with beta-blockers, 16 patients - with verapamil. Research methods included a resting ECG, 24-hour ECG monitoring, echocardiography according to the standard protocol. Results. The treatment was initially started in primarily in more severe patients with severe clinical picture. Verapamil intake reduced complains on palpitations beta-blockers reduced clinical signs of angina. Beta-blockers have objectively reduced the number of ventricular extrasystoles. Significant differences were obtained in average grades of ventricular extrasystoles (2.40±0.54 in patients receiving beta-blockers, 1.05±0.22 in patients not receiving beta-blockers, p <0.01), in ventricular extrasystole number per day (708±327 and 87.3±58.4, p <0.05). No significant effect of treatment on the structural and functional parameters were identified, verapamil reduced the pressure gradient at the pulmonary artery, but increased the obstruction gradient. No effects of drug therapy on the sudden death incidence in the study group were found. Conclusion. Medical treatment for hypertrophic cardiomyopathy is advisable to patients with severe clinical picture because of the possible (in some patients) positive impact on the clinical signs. No significant positive effects of treatment with beta-blockers and verapamil on structural and functional parameters were observed.
Kazan medical journal. 2013;94(5):645-648
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Actual problems of biochemistry and laboratory diagnostics
Functional status of neutrophils at 2,4-dichlorophenoxyacetic acid amine salt intoxication
Akhmetchenko Z.A., Mufazalova N.A., Mufazalova L.F., Remezova A.D., Mukhametzyanova A.Y.
Abstract
Aim. To study the influence of 2,4-dichlorophenoxyacetic acid amine salt subacute intoxication on the functional status of neutrophils. Methods. 2,4-dichlorophenoxyacetic acid amine salt (42 mg/kg) was administered intragastrically during 28 days. The number of leukocytes, neutrophils and lymphocytes in peripheral blood, intensity of oxygen-dependent metabolism (spontaneous and induced tetrazolium test), absorbency, microbicidal activity of neutrophils in conditions of oxygen-dependent microbicidal factors functioning and sodium azide mediated blockade, the level of myeloperoxidase and cation proteins in neutrophils were registered at days 7th and 14th after the toxicant administration discontinuation. Results. Subacute 2,4-dichlorophenoxyacetic acid amine salt intoxication resulted in leucopenia due to neutropenia, accompanied by inhibition of oxygen-dependent neutrophils killing as the result of peroxidase-independent microbicidal mechanisms suppression (reduced synthesis of oxygen active forms). A reduced activity of oxygen-independent killing mechanisms correlating with a decrease of cation proteins levels was also registered. On the 14 day, leucopenia was replaced by leukocytosis due to elevated numbers of neutrophils and lymphocytes in the peripheral blood. At the same time, the activity of both oxidative peroxidase-dependent and oxygen-independent microbicidal mechanisms in neutrophils continued to decrease, accompanied by reduction of mieloperoxidase activity, neutrophil absorbency and cation proteins levels. Conclusion. Subacute intoxication with 2,4-dichlorophenoxyacetic acid amine salt leaded to quantitative and functional disorders in neutrophils that persisted by the 14 day of follow-up, indicating a need for further study of of 2,4-dichlorophenoxyacetic acid amine salt immunotoxic action to find the possible opportunities for its pharmacological correction.
Kazan medical journal. 2013;94(5):649-651
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Efficiency of tactivin and tocopherol for 2,4-dichlorophenoxyacetic acid amine salt hepatotoxicity correction
Akhmetchenko Z.A., Mufazalova N.A., Mufazalova L.F., Remezova A.D., Mukhametzyanova A.Y.
Abstract
Aim. To study the efficiency of individual and combined use of thymus extract (tactivin) and vitamine E (tocopherol) for 2,4-dichlorophenoxyacetic acid amine salt hepatotoxicity correction. Methods. Experiments were carried out on 75 white non-imbred mature rats. Animals were distributed to 5 groups 15 animals each: controls, receiving 2,4-dichlorophenoxyacetic acid amine salt, receiving 2,4-dichlorophenoxyacetic acid amine salt and tactivin, receiving 2,4-dichlorophenoxyacetic acid amine salt and tocopherol, receiving 2,4-dichlorophenoxyacetic acid amine salt and both tactivin and tocopherol. 2,4-Dichlorophenoxyacetic acid amine salt (42 mg/kg) was introduced into the stomach during 28 days. Tocopherol (50 mg/ kg) and Tactivin (0,25 mg/kg) were injected from day 1 to day 6 after the discontinuation of toxin administration. Serum levels of alanine aminotransferase, aspartate transaminase, total and direct bilirubin were examined. The liver morphological state was assessed by microscopy of the liver tissue slices stained with hematoxylin and eosin, electron microscopy was also performed.The results were registered on the 7th day after the toxin discontinuation. Results. 2,4-Dichlorophenoxyacetic acid amine salt led to alanine aminotransferase, aspartate transaminase, total and direct bilirubin levels increase. Hemodynamic alterations, reduced number of mitoses, increased number of necrotic hepatocytes, fiber tissue scarring were observed morphologically. The use of tactivin reduced the severity of morphological changes, and decreased, but did not normalized the level of transaminases and bilirubin. The use of tocopherol normalized the level of transaminases, bilirubin, there were morphological signs of the regeneration processes and hepatocyte mitotic activity intensification. The combined use of tactivin and tocopherol normalized alanine aminotransferase, aspartate transaminase bilirubin levels. Morphologically, signs of regenerative processes and protein synthesis activation were observed in hepatocytes. Conclusion. Tocopherol and Tactivin effectively compensate the hepatotoxic effect of 2,4-dichlorophenoxyacetic acid amine salt, the best result was obtained when both of the drugs used in combination.
Kazan medical journal. 2013;94(5):651-655
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Diagnostic value of vascular endothelial growth factor determination in chronic pyelonephritis in children
Bazarny V.V., Averchenko M.V.
Abstract
Aim. This paper is devoted to the evaluation of clinical and diagnostic value of vascular endothelial growth factor detection in chronic pyelonephritis in children. Methods. The study included 62 patients with different compensation degrees of the disease. Patients were divided into 2 groups - subcompensation (37 patients), and decompensation (25 patients). Renal function was assessed by glomerular filtration rate. Vascular endothelial growth factor concentration was determined by the enzyme-linked immunosorbent assay. To assess the renal vasculature, triplex ultrasonography using pulsed Doppler was performed. The endothelial dysfunction was examined by postocclusion test with reactive hyperemia. Results. Vascular endothelial growth factor level had been significantly increasing in patients according to the severity of the disease. The vascular endothelial growth factor concentration exceeded 600 pg/ml all patients who has later developed chronic renal failure. The sensitivity of this indicator at the abovementioned critical point was assessed as 80%. The change of resistance index reflected renal vascularization disorders. The endothelial dysfunction in postocclusion test was also revealed in patients with pyelonephritis. The vascular endothelial growth factor level highly correlated with the glomerular filtration rate and resistance index. Conclusion. Detecting the vascular endothelial growth factor serum level is one of the tools for endothelial dysfunction laboratory monitoring and renal function assessment in in children with chronic pyelonephritis.
Kazan medical journal. 2013;94(5):656-658
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Level of dioxins and glutathione system status in semen of male patients with infertility
Galimov S.N., Abdullina A.Z., Kidrasova R.S., Galimova E.F.
Abstract
Aim. To evaluate of contamination of ejaculate by polychlorinated Dibenzo-p-dioxins/furans and to analyze the glutathione system status in males with infertility. Methods. 168 infertile and 49 fertile men were examined. Semen analysis was made in accordance with the World Health Organization protocol. The semen levels of persistent organic pollutants (dioxins and furans) was determined by a combination of high-performance capillary gas chromatography and high-resolution mass spectrometry, glutathione-depended enzymes activity - by enzyme-linked immunosorbent assay. Results. It is found that the levels of priority environmental pollutants of dioxins and furans classes was 2,2-2,3 times higher in the semen of infertile men compared to fertile donors. The maximum level of the most toxic congener - 2,3,7,8-tetrachlorodibenzo-p-dioxin - was detected in patients pathospermia, which was found in most infertile patients. The glutathione redox system status in males with infertility was characterized by the decrease in the reduced tripeptide concentration, decreased activity of glutathione-depended xenobiotic detoxification enzymes (glutathione peroxidase and glutathione-S-transferase), multidirectional shifts of metabolism-mediating enzymes (inhibition of glutathione reductase associated with stimulation of g-glutamyltransferase). The molecular mechanisms of polychlorinated dioxins/furans toxicity for the male reproductive system are discussed, which may be mediated by redox state-sensitive signaling systems modulation. Conclusion. Contamination of semen in infertile men by environmental pollutants of polychlorinated dibenzo-p-dioxins and furans classes supports the hypothesis of the relationship of the reproductive pathology with environmental factors. The most important link in the pathogenesis of decreased fertility in men associated with anthropogenic pollution is the change of glutathione antioxidant/antitoxic system activity.
Kazan medical journal. 2013;94(5):658-661
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Biochemical markers of industrial pollutants action on the rubber industry workers
Galiullina E.F., Kamilov R.F., Shakirov D.F., Bulyakov R.T.
Abstract
Aim. To assess the health status of employees contacting with industrial pollutants by examining the processes of free-radical and microsomal oxidation, antioxidant protection, energy metabolism and electrolyte metabolism. Methods. Biochemical parameters of blood, saliva and urine samples of 115 employees of OJSC «Ufa plant of elastomer materials, articles and structures» and 110 employees of JSC «Kauchuk» from the various workshops were examined. Considering the particularities of industrial factors, their action on the employees’ health, ways of absorption at airways, oral cavity and hand skin, two groups (A and B) were formed. Group A included employees contacting with aromatic hydrocarbons (JSC «Kauchuk»). Group B included employees contacting with chlorinated hydrocarbons (OJSC «Ufa plant of elastomer materials, articles and structures»). Control group included administrative clerk workers without influence of industrial factors. Results. Free radical peroxidation reaction with the registration of body fluids chemiluminescence was the most informative biochemical marker of (1,2-dichloroethane, methylene chloride, trichlorethylene, carbon tetrachloride) and aromatic (benzene, 1,2,4,5-tetramethyl benzene, toluene), hydrocarbons action on employees. Сonclusion. Examination of free radical and microsomal peroxidation, antioxidant system, energy metabolism and electrolyte metabolism is a useful prognostic tool for a quantitative assessment of the oxidative processes activity for identification of high-risk groups at picking up the staff for the work related to chemical exposure as well as for the individual prevention and oxidative processes medical correction planning.
Kazan medical journal. 2013;94(5):661-667
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Stomatologic materials biotesting in vitro
Gilmiyarov E.M., Kolesova K.I., Radomskaya B.M., Babichev A.V.
Abstract
Aim. To clarify the specific influence of an adhesive system («Single Bond Universal») on contents, physical and chemical parameters of oral liquid to confirm its safety for use in common dental practice. Methods. A series of in vitro experiments of 5 and 20 seconds of 3 ml oral liquid photopolymerization of 23 dentally and generally healthy subjects aged 18-25 years were performed. Salivary acidity (pH), redox potential, structure, absorption specters, membrane toxicity parameters were assessed. Results. An adhesive system shifted the pH to 6.02±0.21, changed the balance of oxidized and reduced substances with redox potential shift without influencing on salivary structuring. «Filtek Ultimate» and «Filtek Bulk Fill» nanocomposites did not altered the acid-base balance, pH was stable and within the control ranges, redox potential was significantly reduced, mainly by «Filtek Ultimate» (3.6 times lower compared to control parameters), it has also increased the oral liquid structuring by 22,7%. Adhesive and nanocomposites had different effect on the contents of nucleated cells materials (nucleotides, nucleosides, purine catabolites) in oral fluid, decreasing the contents of thymine, cytosine nucleotides and their derivatives, confirmed by absorption characteristics of oral fluid after the incubation. It was found that «Single Bond Universal» adhesive system, «Filtek Ultimate» and «Filtek Bulk Fill» nanocomposites also change the physical and chemical parameters of oral liquid and have a membrane-toxic effect on red blood cells. Conclusion. Biotesting of specified stomatologic materials showed that they are not completely bioinert.
Kazan medical journal. 2013;94(5):667-672
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Key parameters of carbohydrate metabolism in healthy people with different AB0 blood groups
Gilmiyarova F.N., Kolotyeva N.A., Gusyakova O.A., Nefedova N.S., Shahnovich E.A., Gergel N.I.
Abstract
Aim. To study the particularities of metabolism associated with AB0 system blood groups by examination of carbohydrate exchange serum parameters. Methods. 446 healthy subjects with different blood groups were examined: 0 (I) blood group - 29.6%, A (II) - 31.8%, B (III) - 24.3%, AB (IV) - 14.3%. The blood group was defined by direct agglutination test in all subjects, piruvate, lactate, glucose, cortisol and insulin serum levels, lactatdehydrogenase and α-аmylase activity was defined using an automatic biochemical analyzer. Results. Group specific features of carbohydrate metabolism in subjects with different blood groups were revealed. In subjects with 0 (I) blood group the lowest glucose and insulin serum levels, the highest amylase activity and piruvate and lactate blood levels were characteristic; in subjects with A (II) blood group - highest level of insulin and cortisol, low lactate levels; in subjects with B (III) blood group - maximal lactatdehydrogenase and minimal amylase activity, high piruvate and lactate blood levels; in subjects with AB (IV) blood group - highest level of glucose, low lactatdehydrogenase and amylase activity, lowest lactate and piruvate blood levels were revealed. Conclusion. The particularities of molecular processes might be associated with blood group and predispose to different health conditions. The features of the metabolic profile of patients with different blood groups are the rationale for individualization of personal standards for each person that might reasonably be considered in clinical practice.
Kazan medical journal. 2013;94(5):672-674
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Bone mineral density and calcium intake in primary schoolchildren of the southern region of Bashkortostan Republic
Golovatskih I.V., Bikmetova E.R., Kamilov F.H.
Abstract
Aim. To study the bone mineral density and level of calcium intake in children aged 8 and 9 years living in the southern region of Bashkortostan republic. Methods. Bone mineral density was determined by quantitative ultrasound in 180 primary school pupils (86 boys and 94 girls), average age was 8,3±0,66 years. Physical development was assessed by body weight and height, calcium intake was evaluated, calcium, phosphorus, magnesium serum levels were assessed. Results. Results of quantitative ultrasound of radial bone in boys were slightly lower than the national standards determined for 8-9 years old children, while in girls and at quantitative ultrasound of tibial bone the results were within and even exceed normal ranges. At the same time, bone mineral density of M-1SD (radial + tibial bone) and lower was registered in 6,3% of boys and in 6,6% of girls. Body mass index was 16,54±0,24 kg/m 2 in urban pupils, 16,55±0,32 in rural pupils; 2,9% of rural and 17,9% of urban schoolchildren were underweight, 22,6 and 28,1% were overweight. Food calcium intake was characterized as moderate deficiency, only 11% of children took the recommended daily amount of calcium, their share was lower in the rural areas (7,2%) compared to urban (15%). The number of daily consumed dairy was 1,5-2,6 times below the age standards, with the average intake reaching only 26-39% of recommended. Insufficient calcium intake reflected in growth rates - the share of undersized children was lower in urban areas than in rural areas. Calcium, phosphorus, magnesium serum levels were within the normal ranges. Calcium serum level was somewhat higher, and magnesium serum level - lower in boys compared to girls. Conclusion. Bone mineral density parameters in primary schoolchildren were within the normal ranges. Calcium food intake corresponds to 50-70% of the age norm.
Kazan medical journal. 2013;94(5):675-677
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Experience in developing graphical user interface to R programming language for clinical and experimental data analysis
Dolgikh T.I., Serbaev D.A., Chekmarev G.V., Kadcyna T.V.
Abstract
Aim. To develop the software product for of medical data analysis and public health indicators presentation. Methods. R_MED software - an interface for typical experimental, clinical and laboratory, epidemiologic analysis using the R system opportunities - was developed. Results. Functionally, the program consists of the following blocks: «Load Data», «Settings», «Basic calculations», «Data Mining», «Presentation of health indicators». Interface simplifying is also achieved by the inclusion of only those methods that are most often required in medical data analysis. So, the «Basic calculation» unit includes the following statistical calculations: descriptive statistics for quantitative variables, frequency tables, bar charts and box plots, Pearson’s correlation matrix, Pearson’s linear correlation, Spearman’s rank correlation, Spearman’s correlation matrix, 2D scatter plots, defining the difference in two independent sample groups using Student’s test and the Mann-Whitney test, analysis of variance (ANOVA). In the «Settings» unit, a user can choose a set of variables and observations for analysis, to change the set of features for any value, to add, delete, rename the variable, and optionally customize the «Load Data» mode, the basic calculation, and data output. The program provides the ability to visualize data using «Presentation of health indicators» block in the context of territory, year and variant. Territorial cuts can be differentiated into three levels: municipal, regional, district (Federal District) level. To construct the maps, vector data on all 3 spatial levels are stored in the R_MED system, including the Federal Districts of Russian Federation. Conclusion. Originally developed for research problems solving of pathology risk forecasting, the R_MED program, if configured properly, can also be used in other clinical diagnostic and epidemiological studies to monitor problems of socially significant diseases and of health services, as well as in the preparation of annual statistical reports, including the regional level.
Kazan medical journal. 2013;94(5):677-681
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Prognostic factors for anti-cancer therapy efficiency
Erlykina E.I., Kopytova T.V., Alyasova A.V., Terentiev I.G., Gorshkova T.N., Pimenov V.G., Evdokimov I.L., Obukhova L.M.
Abstract
Aim. To investigate the relationship between blood plasma biochemical indicators in patients with solid tumors before a treatment and after the first course of chemotherapy with objective treatment response. Methods. Blood plasma samples taken from 14 patients with cancer relapse were studied before the treatment and after the first course of specific chemotherapy (carboplatin, methotrexate, vinblastine in patients with urine bladder cancer and irinotecan, leukovorin and fluorouracil in patients with colorectal cancer). The first group included patients with colorectal cancer relapse (males - 3, females - 4) aged 57-62 years. The second group included patients with urine bladder cancer relapse (males - 5, females - 2) aged 48-64 years. Free radical activity and protein oxidative modification, as well as endogenous intoxication and major mineral and trace elements levels were studied. Results. When achieving the objective chemotherapy effect in patients after the first treatment course, an increase of alpha-1 globulin and gamma globulin level, as well as an increase of phosphorus, zinc, lithium and iron blood plasma level was observed. In case of following disease progression, the opposite dynamics of above-mentioned indicators was revealed. In patients with good objective effect of polychemotherapy after the first treatment course, a significant increase of endogenous intoxication and blood plasma free radical activity decrease were observed. If the following tumor progression was observed, the tendency of blood plasma free radical activity increase, accompanied by the total protein oxidative modification activation, was revealed after the first treatment course. Conclusion. The increase of alpha-1 and gamma globulin levels, as well as an increase of phosphorus level in blood plasma after the first course of polychemotherapy can be used as prognostic factors of anticancer therapy efficiency. High level of endogenous intoxication as well as an increase of copper, iron, zinc and lithium blood plasma concentrations can be applied as the additional markers.
Kazan medical journal. 2013;94(5):681-685
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Pathogenetic approach to venous thrombosis markers examination
Zubairova L.D., Mustafin I.G., Nabiullina R.M.
Abstract
The review summarizes experimental and clinical findings decrypting the mechanisms that initiate venous thrombosis. It is still relevant to consider the pathogenesis of venous thrombosis within the frames of the classic Virchow’s triad, and the mechanisms of interrelation of its separate mechanisms - changes in blood composition, blood flow, or alterations of the blood vessel wall - becomes more clear. Changes in the blood constituents include the amount and functional state of proteins and hemostasis system cells. Among the important changes in blood flow are blood flow rate, affecting the cells and coagulation proteins transport to the site and from the site of thrombosis, and the local shear stress, modulating adhesion and procoagulant activity of endothelium and platelets. Vascular wall provides tissue factor, which is the initiator of blood coagulation; phospholipid surface of cell membranes and microvesicles for assembling coagulation enzyme complexes, as well as adhesion proteins for the blood platelets and leukocytes «capturing». Decreased venous blood outflow and stasis, causing the local hypoxia, are associated with procoagulant changes in blood cells: the expression of P-selectin on endothelium increases, leading to the accumulation of leukocytes and cell microvesicles containing the initiator of blood coagulation - tissue factor. The local concentration of activated clotting factors increases, which along with anticoagulant activity alterations initiates progressing fibrin formation and thrombogenesis. Marking out the key mechanisms allows using them as the potential markers for diagnosing venous thrombosis risk. Among them are cell derived microparticles, cytokines, P-selectin that are investigated as possible indicators of deep vein, pulmonary, cancer associated thrombosis.
Kazan medical journal. 2013;94(5):685-691
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Antiaggregatory activity of new 1-ethylxanthine cyclohexylammonium salt in vitro
Kamilov F.K., Timirkhanova G.A., Samorodova A.I., Samorodov A.V., Khaliullin F.A., Murataev D.Z.
Abstract
Aim. To study the biochemical effect on hemostasis of a new cyclohexilammonium salt of 2-[1-ethyl-3-methyl-7(dioxotiethanyl-3)xantinyl-8-thio]acetic acid in vitro. Methods. Thromboelastography was performed using the citrate blood samples of healthy male donors. Global hemostatic effect, fibrinogen and platelet function, fibrinolysis and clot strength, and stability were analyzed at thromboelastography. The impact of firstly synthesized xantine derivative and pentoxifylline on the functional activity of platelets in vitro was studied using a laser analyzer of platelet aggregation. Adenosine diphosphate, collagen, epinephrine and ristocetin induced clotting were registered. General clotting characteristics, maximal aggregation values, maximal aggregation speed, mean platelet aggregate size, activity of platelet-derived factor 3, level of platelet-derived factor 4 were measured. Release of platelet-derived factors 3 and 4 at platelet aggregation were assessed after adenosinediphosphate-induced aggregation and centrifugation. Results. Cyclohexylammonium salt of 2-[1-ethyl-3-methyl-7-(dioxotiethanyl-3)xantinyl-8-thio]acetic acid in vitro showed antiaggregatory activity that exceeds such of pentoxifylline. It has been revealed that the second platelet aggregation wave, that is induced by small dose of adenosinediphosphate, is absent in the presence of the new cyclohexylammonium salt, lag-period in collagen-induced platelet aggregation elongates, and availability and release of platelet-derived factors 3 and 4 decreases. Conclusion. The research findings show potentially high antiaggregatory activity of 2-[1-ethyl-3-methyl-7-(dioxotiethanyl-3)xantinyl-8-thio]acetic acid cyclohexylammonium salt as an inhibitor of platelet release reaction.
Kazan medical journal. 2013;94(5):692-695
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Neurotrophic factors concentration in rat brain at the experimental coma
Kashuro V.A., Batotsyrenova E.G., Elaeva N.L., Savenko U.N., Lapina N.V., Aksyonov V.V.
Abstract
Aim. To study the changes of neurotrophic factors concentrations depending on stage of intoxication with deprivation substances (ethanol or sodium oxybutirate) in rats. Methods. Experiments were performed on male white laboratory rats. Control and experimental groups included 10 animals each. Half-lethal doses of a deprivation substance (ethanol or sodium oxybutirate) were introduced intraperitoneally 3, 6, 12, 24 and 72 hours before blood specimen collection. Neuron-specific enolase, S-100 protein, brain-derived neurotrophic factor, pigment epithelium-derived factor, glial fibrillary acidic protein serum levels were measured by enzyme immunoassay. Results. At single infusion of mean lethal dose of sodium oxybutyrate S-100 protein serum level significantly increased after 6 hours compared to control and stayed elevated during the first 24 hours. The levels of neurotrophic and neuroprotective factors also significantly increased 3 and 6 hours after the drug administration. The toxic dose of ethanol have significantly increased (over than 1.8 times compared to the controls) the concentration of protein S-100 in rats after 3 hours. The maximum increase in the protein S-100 level (by 2.6 times and over) was noted 12 hours after the toxicant administration. Glial fibrillar acidic protein concentration was 2.9 times higher compared to controls 3 hours after and 1.9 times higher 6 hours after higher the ethanol administration (р <0.05). The concentration of brain - derived neurotrophic factor has also increased from 3 to 12 hours after the toxicant administration, and was 2.1 to 2.4 times higher compared to intact animals. Conclusion. Studying of neurotrophic factors brain in plasma showed that the development of hypoxia, accompanying coma, leads to higher serum levels of S-100 protein, brain-derived neurotrophic factor and glial fibrillar acidic protein. The increase in the concentration of S-100 is a marker for the presence of brain damage. The observed increase of glial fibrillar acidic protein in experiments with ethanol may indicate its more severe brain tissue damage compared to sodium oxybutyrate.
Kazan medical journal. 2013;94(5):695-699
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Novel perspective substances with selective anti-aggregant action
Kiselev S.V., Nikitina L.E., Vorontsova M.M., Turaev R.G.
Abstract
Aim. To study the influence of new sulfur-containing derivatives of β-pinene on the platelet aggregation ability and coagulant activity of human serum in vitro. Methods. A series of sulfides and sulfoxides have been synthesized based on β-pinene. Sulfides have been synthesized by the electrophilic addition reaction of thiols to the double bond of β-pinene in the presence of ZnCl 2. Sulfides were oxidized to sulfoxides by such oxidizing agents as sodium periodate, meta-Chloroperoxybenzoic acid, selenium dioxide with hydrogen peroxide and sulfuryl chloride in combination with ethyl alcohol. The best result was achieved by asymmetric oxidation method using the Ti(O-i-Pr) 4/(R)-mandelic acid /t-BuOOH oxidation system. Structure of synthesized compounds was ascertained by 1Н and 13С nuclear magnetic resonance, chromatomass spectrometry and X-ray structural analysis. Clotting activity of synthesized substances was evaluated by platelets aggregating rates and standard surface-dependent coagulation tests. Venous blood from patients with ischemic heart disease and evident changes in hemostasis system were used to determine spontaneous platelets aggregation and serum clotting activity. The induced platelets aggregation was studied on serum obtained from healthy donors. Results. The basic substance (β-pinene) did not influence the hemostasis system status in patients with ischemic heart disease. The substances synthesized on its basis have shown high anti-aggregatory activity: spontaneous velocity and aggregation coefficient reduced significantly and even reached normal values in some cases. Besides, they reduced the serum clotting activity, normalized activated partial thromboplastin time, prothrombin time international normalized ratio. However, the activity of thrombin was not influenced. The most water-soluble sulfoxide showed the most activity and almost completely inhibited spontaneous and collagen-induced and arachidonic acid-induced platelet aggregation, as well as better reduced the serum clotting activity in patients with ischemic heart disease compared to other synthesized substances. Conclusion. Taking into account low toxicity of thioterpenoids, the novel substances can be described as potentially promising drugs for medical treatment and prevention of thrombophilia and as agents for blood stabilization.
Kazan medical journal. 2013;94(5):700-704
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Lactate concentration in amniotic fluid at early neonatal period in perinatal hypoxia
Korenovsky Y.V., Chugunova T.N., Filchakova O.N., Sinelnikova L.M., Shabalina Y.V., Elchaninova S.A.
Abstract
Aim. To determine the prognostic value of lactate concentration in amniotic fluid and umbilical cord blood of newborns at early neonatal period as indicators of increased risk of unfavorable outcome in infants with perinatal hypoxia. Methods. Determination of lactate and creatinine concentration in amniotic fluid at first stage of labor was performed by biochemical means. Determination of lactate concentration in the blood serum of infants at birth and at 3-4 days of life was also performed. Results. In timely delivery associated with perinatal hypoxia lactate concentration in amniotic fluid was increased compared to the lactate concentration in amniotic fluid during normal labor (10.6±3.18 vs 7.1±1.45 mmol/l, p <0.001). Recalculation of the lactate concentrations in amniotic fluid considering its dilution has showed a substantial difference in concentrations (0.083±0.016 vs. 0.039±0.003 mmol/l of lactate per 1 mmol/l creatinine, p <0.001). Cord blood serum lactate concentrations in newborns with perinatal hypoxia was higher compared to healthy infants (16.4±4.96 vs 9.5±3.16 mmol/l, p <0.001). Lactate concentration in umbilical cord blood serum in early neonatal period newborns rose (p <0.001), and in infants with perinatal hypoxia the increase was more significant compared to in healthy newborns (28.1±7.75 vs 13.3±3.50 mmol/l, p <0.001). Conclusion. The determination of lactate concentration in amniotic fluid at first stage of labor is an effective method to diagnose perinatal hypoxia. In early neonatal period an increase of lactate concentration in newborns, especially in newborns with perinatal hypoxia, was found.
Kazan medical journal. 2013;94(5):704-706
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Blood biochemistry parameters in patients with hemophilia
Kosyakova Y.A.
Abstract
Aim. To describe the blood biochemistry parameters in patients with hemophilia considering the level of lacking coagulation factor and AВ0 blood group to clarify the risk factors for complications of hemophilia and concomitant diseases. Methods. 300 patients with hemophilia A admitted due to bleedings were examined. The serum levels of albumin, urea, bilirubin, cholesterin, iron, aspartate aminotransferase were examined using an automatic biochemical analyzer. The control group included 185 healthy males of similar age. Results. Severe degree of hemophilia was diagnosed in 42% of patients, medium severity - in 36%, mild - in 22%. Low metabolic activity was found in patients with hemophilia. Blood cholesterol level of 3 mmol/l and less was the risk factor of anemia development in patients with hemophilia of any severity. In hemophilic patients with 0(I) blood group, serum iron level decrease was registered regardless of hemophilia severity, in patients with other blood groups decrease was noted in patients with medium and severe hemophilia. Serum iron level of 12 μmol/l and less was the risk factor for anemia. The albumin level was the highest in patients with AB (IV) blood group, with only a few cases of anemia diagnosed in these patients. Conclusion. In patients with hemophilia there is a tendency of losing cholesterol and serum iron while bleeding, which is the risk factor for anemia and other concomitant conditions development. Treating patients with hemophilia, it is important to consider the specific personal metabolic features associated with the AВ0 blood group and the level of lacking coagulation.
Kazan medical journal. 2013;94(5):707-710
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Molecular mechanisms and clinical significance of fibrinolysis
Litvinov R.I.
Abstract
Fibrinolysis is the process of proteolytic digestion of fibrin aimed in vivo at dissolving clots or thrombi to restore the blood flow. In blood, the fibrinolytic system comprises a network of interrelated biochemical reactions that occur predominantly on the surface of fibrin fibers, the structural scaffold of hemostatic clots and obstructive thrombi. This review provides a brief description of the fibrinolytic system components and of the most important fibrinolytic reactions, including their modulation. The central enzyme in fibrinolysis is plasmin, a serine protease formed from its inactive precursor, plasminogen, upon the action of proteins and enzymes, whose formation and/or activation is triggered by various pathological stimuli. Plasmin cleaves a variety of substrates other than fibrin and therefore is involved in a number of biological processes other than hemostasis and thrombosis. There are several mechanisms moderating the activity of fibrinolytic enzymes that may become altered in various diseases. When the ratio of blood pro-and antifibrinolytic compounds is altered, hyper-or hypofibrinolysis might develop that causes and/or exacerbates hemorrhage or thrombosis, respectively. The paper contains an original pathogenic classification of fibrinolytic disorders and describes mechanisms of the primary and secondary hypo-and hyperfibrinolysis in various pathological conditions. Diagnosis of fibrinolytic defects builds on clinical symptoms along with defining the time of serum clots dissolving in vitro and serum levels of molecular markers. The principles of laboratory diagnostics of pathological fibrinolysis, based on the comprehension of the molecular mechanisms of normal and impaired fibrinolytic reactions, are reviewed. Treatment of pathological fibrinolysis implies the correction of either hyper-or hypofibrinolytic conditions and, therefore, is based on the administration of either antifibrinolytics (ε-eminocaproic and tranexamic acids) or thrombolytics (mainly, plasminogen activators) in combination with other therapies against bleeding and thrombosis.
Kazan medical journal. 2013;94(5):711-718
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The influence of phychoemotional stress on white blood cells circulation and thrombodynamics in healthy volunteers
Lozhkin A.P., Chernokhvostov Y.V., Dvoenosov V.G., Panasyuk M.V., Zhdanov R.I.
Abstract
Aim. To characterize the influence of psychoemotional stress on a white blood cells number in peripheral blood and clotting parameters. Methods. Lymphocytes, granulocytes, monocytes blood counts and coagulological testing were performed in fifty-one students (26 males and 25 females) during the midyear examinations. Psychological tests were used to reveal stress resistance and predisposition to stress. Results. The higher monocyte counts were found in male group under stress compared to control group. Meanwhile, female group under stress showed higher percentage of granulocytes and lower percentage of lymphocytes compare to control group. Sex differences in stationary speed of clot formation were found in stress and non-stress groups. Both sex groups showed an association of psychoemotional stress and hemostasis parameters, the differences in male group were more marked. Conclusion. The obtained data suggest that psychoemotional stress modulates immune cells and hemostasis parameters in healthy volunteers.
Kazan medical journal. 2013;94(5):718-722
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Features of cellular and molecular inflammatory mechanisms involvement in hormone-mediated myocardial experimental injury
Mayanskaya N.N., Hidirova L.D., Mayanskaya S.D.
Abstract
Aim. To study the features of inflammatory effector mechanisms variation in Wistar rats with metabolic non-coronary myocardial infarction. Methods. Metabolic myocardial infarction was reproduced in Wistar rats by adrenalin injection. Metabolic myocardial infarction was verified by electrocardiography and histological examination. Biocidal activity of blood neutrophils was determined by nitro blue tetrazolium test and chemiluminescence, cytokine serum levels (interleukin-1β, interleukin 6 and tumor necrosis factor alpha) were determined by ELISA. Lipid peroxidation was assessed by measuring malondialdehyde, diene conjugates and diketones blood concentrations. Catalase activity and reduced glutathione level were determined in erythrocyte hemolysate, serum activity of superoxide dismutase was also measured. Intact animals were examined as a control group. Results. In rats with metabolic myocardial infarction, oxygen-dependent leukocyte biocidity (determined by nitro blue tetrazolium test and chemiluminescence) increased dramatically from the first day of the adrenalin administration and continued to increase until the end of the experiment (day 14). Accordingly, the production of active oxygen metabolites, which intensified the lipid peroxidation, was increasing. Simultaneously an imbalance between pro-and antioxidant system parameters was detected. Serum concentration of pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin-1β, interleukin-6) increased. Conclusion. Long-term administration of adrenalin to experimental animals causes an increase in the neutrophils biocidal activity, accompanied by release of reactive oxygen species, pro-inflammatory cytokines, lipid peroxidation intensifying and decreased compensation by antioxidant defense system, which together can be a powerful trigger of myocardial damage.
Kazan medical journal. 2013;94(5):723-726
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Features of inflammation course in rats with experimental hyper- and hypothyroidism
Mayanskaya N.N., Rimar S.S., Mayanskaya S.D.
Abstract
Aim. To mark out the features of inflammatory reactions alterations in rats with experimental thyroid gland dysfunction. Methods. Experimental hypothyroidism was modeled by daily thiamazole intake in 50 Wistar rats. Hyperthyroidism was modeled with daily lyothyronine intake in 50 Wistar rats. An inflammation was modeled by artificial gum injury. 10 intact rats were examined as a control group. Results. Experimental hypothyroidism was accompanied by leukocyte biocidity decrease both in blood and periodontium, decreased lysosomal enzymes activity and antioxidant activity, and accumulation of lipid peroxidation products. Periodontal suppurations at experimental inflammation were 1.5 more frequent in rats with hypothyroidism compared to controls due to decreased leukocyte biocidity and antioxidant activity. Experimental hyperthyroidism was associated with increased biocidity and decreased functional reserves in phagocytes both in blood and periodontium, as well as antioxidant activity decrease and lipid peroxidation intensification. Changes of tumor necrosis factor alpha blood concentration both in hypothyroidism and hyperthyroidism corresponded with changes of phagocyte biocidity. The rate of periodontal suppuration in rats with hyperthyroidism was twice lower on the day 7 compared to controls due to high leukocyte and macrophage biocidity. Conclusion. Experimental hypothyroidism was accompanied by intensifying of lipid peroxidation and decreased tissue reparation ability; experimental hyperthyroidism was associated with increased biocidity and decreased functional reserves in phagocytes, and less evident decrease of compensatory abilities of antioxidant system lipid peroxidation intensification compared to hypothyroidism.
Kazan medical journal. 2013;94(5):726-730
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Calciuria intensity and bone mineral density in chemical industry employees
Menshikova I.A., Kamilov F.H., Mufazalova L.F., Ivanova G.V.
Abstract
Aim. To determine the severity of calciuria and bone mineral density strength in a soda-producing chemical plant employees. Methods. The study included 267 workers of OJSC «Soda» (Sterlitamak, Republic of Bashkortostan), aged 18 to 60 years. The bone metabolism, bone mineral density by quantitative ultrasonography were assessed, 10-year risk of fractures due to osteoporosis was calculated. Results. Low mineral density (osteopenia) was found in 87 (32.6%) female employees of the manufacturing department. Osteoporosis with moderate risk of fractures due to osteoporosis (the probability of 8.7%) was diagnosed in 13 (4.9%) female employees aged over 50 years. The main industrial factors, negatively influencing the bone metabolism, were exposure to certain chemicals (hydrocarbons, hydrogen sulfide, benzene, sulphuric, hydrochloric, nitric acids, formaldehyde, alkali). Laboratory staff was the most frequently exposed to these chemicals. So, osteopenia was diagnosed in 14 out of 36 (38.9%) laboratory analysts, osteoporosis was diagnosed in 3 laboratory employees (8.3%) aged over 50 years, with work experience more than 10 years. Increased total alkaline phosphatase (an enzyme that indirectly reflects the activity of bone resorption) activity was found in employees with osteoporosis and osteopenia. Significant changes were observed in urine calcium levels, with the daily excretion higher than normal. The study of one of the available bone resorption markers - a calcium and creatinine molar ratio - showed increased values in 17 employees. Conclusion. Chemical compounds that employees may contact during the entire day shift may negatively influence the bone metabolism, activating bone resorption, decreasing bone mineral density and increasing the risk for fractures. Calciuria degree reflects the intensity of osteopenia and osteoporosis.
Kazan medical journal. 2013;94(5):730-733
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Biochemical studies of tears in patients with diabetes mellitus and dry eye syndrome
Nugumanova A.M., Khamitova G.H.
Abstract
Aim. To study the lacrimal fluid glucose level in patients with diabetes and dry eye syndrome with hyperglycemia and after compensation. Methods. Glucose oxidase method was used to determine the level of glucose in tears of 40 patients with diabetes (80 eyes) who were treated at the endocrinology department. Of these, the diagnosis of diabetes mellitus (DM) type 1 has been established in 17 (42.5%) patients, type 2 - in 23 (57.5%). The study also included the control group, which included 20 healthy volunteers (40 eyes) aged 25 to 45 years (12 females, 8 males). Three groups were formed: healthy subjects, patients with diabetes mellitus and no signs of dry eye syndrome, patients with diabetes mellitus and clinical signs of dry eye syndrome. Results. Glucose level in the tear fluid of healthy individuals did not exceed 0.2 mmol/l. No signs of «dry eye» syndrome were found in patients with blood glucose levels up to 9 mmol/l (2nd clinical group). Patients of 3rd group were observed with the clinical symptoms with «dry eye» syndrome if there was an increase of blood glucose level over 17 mmol/l, tear glucose levels were also increased to 7 mmol/l. After the treatment the level of blood glucose in the patients of the second group decreased from 9 to 5 mmol/l, while tear glucose levels decreased from 1.2 to 0.5 mmol/l. In the third group the same clinical pattern was observed: reduction of blood glucose from 17.1 to 7 mmol/l was accompanied by a decrease of tear glucose levels from 7 to 1 mmol/l. There was a reduction of the subjective complaints characteristic for dry eye syndrome in patients from the third group. Conclusion. «Dry eye» syndrome is associated with increased tear glucose levels. The blood glucose level control is one of the methods of dry eye syndrome prevention in patients with diabetes mellitus.
Kazan medical journal. 2013;94(5):733-735
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Oxidative stress modeling in the blood lymphocytes in vitro to examine the Jurkat line tumor cells apoptosis
Ryazantseva N.V., Stepovaya E.A., Konovalova E.V., Nosareva O.L., Naumova A.I., Orlov D.S., Vesnina O.N., Novitsky V.V.
Abstract
Aim. To experimentally select the optimum concentration of hydrogen peroxide capable of efficiently induce oxidative stress and launch the programmed death of the maximum number of lymphocytes, but not induce the necrosis. Methods. Jurkat tumor cell line (human T-lymphoblastic leukemia) lymphocytes isolated from the blood of healthy donors (15 males, 18 females) aged 18 to 25 years were the objects of the study. To confirm the object of study, blood cells typing for CD5 using flow cytometry was performed. To model the oxidative stress in vitro, blood lymphocytes were incubated in the presence of hydrogen peroxide at a final concentration of 0.3, 0.5, 1.0 and 2.0 mM. Reduced and oxidized glutathione levels estimation, the ratio between the fractions, and the level of reactive oxygen forms in lymphocytes for a relative assessment of the oxidative stress degree in cancer cells, were used. Results. An optimal final concentration of hydrogen peroxide - 0.5 mM - was established, causing an increase of active oxygen forms concentration in cells, comparable to levels in tumor cells, the formation of a maximum number of annexin positive cells and minimum number propidium-positive cells and the comparable ratio of the reduced and oxidized glutatione levels. Conclusion. The optimum concentration of hydrogen peroxide (0.5 mM) was selected for the oxidative stress formation in the peripheral blood lymphocytes to study the apoptosis dysregulation in oxidative stress in Jurkat line tumor cells (human T-lymphoblastic leukemia).
Kazan medical journal. 2013;94(5):736-740
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Hormonal imbalance in prenatally alcoholized rat offspring
Samuseva N.L., Kurch N.M., Vysokogorskiy V.E.
Abstract
Aim. To identify the role of hormonal imbalance in the development of hypoglycemia in rats exposed to prenatal alcohol intoxication. Methods. Effects of prenatal alcohol intoxication on carbohydrate metabolism regulation in rat youngs aged 15, 30 and 60 days were studied. For this purpose, intragastral injections of 40% ethanol (4 g/kg) were performed in female white random rats during the gestation period. Glucose, insulin, glucagon, cortisol, thyroid hormones serum concentrations were determined. Results. In offspring of rats exposed to alcohol during the prenatal period, increased blood insulin concentration at the age of 30, 60 days, reduced glucagon concentration at the age of 60 days were found. These changes were accompanied by persistent hypoglycemia. Plasma cortisol concentration in rats exposed to alcohol during the prenatal period had no any statistically significant differences compared to a control group. Statistically significant reduction of triiodothyronine in the age of 60 days accompanied by an increased blood thyroxin level was also observed. Conclusion. The gained results suggest the essential influence of prenatal alcohol intoxication on carbohydrate metabolism regulation in the remote terms of postnatal period. Prenatal alcohol exposure leads to the development of differently directed changes in offspring blood insulin, glucagon and thyroid hormones remaining in remote periods of postnatal ontogenesis, that may play a significant role in the development of hypoglycemia, and define the high level of the still birth and early postnatal mortality.
Kazan medical journal. 2013;94(5):740-743
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The characteristics of serum circulating immune complexes of patients with atopic asthma with different severity degree
Skibo Y.V., Kurmaeva N.S., Tsibulkina V.N., Mustafin I.G., Abramova Z.I.
Abstract
Aim. To evaluate the serum level of pathogenic circulating immune complexes in patients with mild and severe atopic bronchial asthma. Methods. Serum samples of patients with atopic asthma of mild persistent (30 patients) and severe persistent (20 patients) forms were analyzed. The control group consisted of 15 healthy volunteers. To detect the giant, large, medium and small-sized serum immune complexes, 3, 3.5, 4 and 7% polyethyleneglycol-6000 solutions were used. For quantitative evaluation of the immune complexes we measured the ultraviolet optical density at 280 nm wave length. To separate the immune complexes from immunoglobulin, Protein-G-Sepharose was used. Determination of the protein composition of circulating immune complexes was performed by electrophoresis in 8% polyacrylamide gel. Results. The concentration of immune complexes was increased in patients with bronchial asthma compared to healthy donors. Small and medium-sized immune complexes were prevailing, their concentrations correlated with the severity of asthma. Large, medium and small-sized immune complexes participated in immunopathological reactions in patients with both mild and severe asthma, with immune complexes pathogenicity coefficient significantly increased depending on the severity of the disease. Electrophoretic analysis of circulating immune complexes has shown the presence of proteins with molecular weight of 60 kDa in the complexes of all sizes. In the severe asthma group, an antigen fraction with a molecular mass of 36 kDa within the small-sized molecular complexes was revealed. Conclusion. The observed increase of small and medium-sized circulating immune complexes serum levels in patients with bronchial asthma may be an indicator of of these patients predisposal to autoimmune reactions development.
Kazan medical journal. 2013;94(5):744-748
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Association of missed miscarriage and fetal chromosomal disorders
Spiridonova N.V., Kalinkina O.B., Gilmiyariova F.N., Meleshkina O.I.
Abstract
Aim. To study the frequency of chromosomal disorders as a cause of missed miscarriage. Methods. 328 women aged 30,34±0,34 years with missed miscarriage at 3 to 22 weeks of gestation were examined. the missed miscarriage was diagnosed by ultrasonography and human chorionic gonadotropin blood level. Endometrectomy with further scrape cytogenic examination were preformed. The preparations for cytogenic examination were obtained by unified direct express-method, karyotyping was performed after the routine and differentiated staining. Results. Fetal karyotype was defined in 88 women. In 54 (61.4%) women, chorionic villi and placenta of miscarried fetuses had chromosome pathologies, in 34 (63%) women - at 1 st trimester, in 20 (37%) - at 2 nd trimester. High frequency of pathological karyotypes identification was observed in 29 (65,9%) women with first pregnancy, compared to 26 (59.1%) women with second and subsequent pregnancies. The following pathologies were found: autosomal trisomy - in 32 (59.3%) women, triploidy - in 8 (14.8%) women, X-chromosome monosomy - in 6 (11.1%) women, polyploidy - in 6 (11.1%), tetraploidy - in 2 (3.7%) women. It was the first missed miscarriage in 268 women (81.7% of cases), with 23 genetic anomalies found in 23 (52.3%) of such cases. In women with repeated missed miscarriage, fetal genetic disorders were revealed in 34 (77.1%) of cases. Female karyotype was found by 7,4% more frequent compared to male karyotype: 29 (53.7%) versus 25 (46.3%) cases. Fetuses with polysomy (double and triple trisomy) and triplody were eliminated at 5-6 weeks of gestation, fetuses with 22 chromosome trisomy at 6-7 weeks of gestation, with 18 chromosome trisomy - at 7-8 weeks of gestation, with X monosomy - at 8-9 weeks of gestation, with 16 chromosome trisomy - at 10-11 weeks of gestation. No relations of fetal karyotype mutations to maternal body mass index were revealed. Conclusion. High frequency of trisomy, as well as in the case of X-chromosome monosomy, points at high incidence and high percentage of autoelimination of the fetuses having this pathology. The presence of pathological karyotype is the reason for earlier pregnancy termination.
Kazan medical journal. 2013;94(5):748-751
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Comparative analysis of ceruloplasmin level in biological fluids at herpes infection
Terekhina N.A., Reuk S.E., Atamanova T.I.
Abstract
Aim. To compare the levels of ceruloplasmin in tears, saliva and blood serum of patients with herpetic stomatitis and eye herpes to evaluate the effectiveness of treatment. Methods. Ceruloplasmin levels were determined in tears, saliva and blood serum of 30 children, 22 adult patients with herpetic keratitis and 27 children with acute herpetic stomatitis. Biological fluids of 62 healthy individuals were used as the control group. Results. In patients with eye herpes infection, сeruloplasmin levels increased in oral fluid and blood serum and markedly decreased in tears of both affected and intact eye. Ceruloplasmin levels in biological fluids normalized only among children with light forms of eye herpes at discharge. In the case of acute herpetic stomatitis, ceruloplasmin levels increased in oral fluid and blood serum, depending on the severity of the disease. After the treatment, ceruloplasmin levels in tears, oral fluid and blood plasma normalized only in children with dendritic ulcer (herpes epithelial keratitis), while in adult patients with chronic relapsing eye herpes and in children with highly invasive eye herpes ceruloplasmin levels did not normalize. Conclusion. In the case of infection detected multidirectional ceruloplasmin levels in tears, oral fluids and blood serum changes were found in patients with herpes. Ceruloplasmin level decreased in tears, and increased in blood serum and oral fluid.
Kazan medical journal. 2013;94(5):752-754
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The development of the blood clotting initiation conceptions: from A.A. Schmidt to D.M Zubairov
Timerbaev V.N., Kiselev S.V.
Abstract
The objective of the review is to cover the formation of modern understanding of molecular mechanisms of blood coagulation initiation. It was provided mainly by the research of Professor D.M. Zubairov and his colleagues. Since 1963, he has established that blood coagulation initiation is not connected to the phenomenon of vascular wall moistening and contact complex factors activation. Research of the thromboplastic activity distribution in tissue cells, blood and in the serum phospholipid microparticles allowed to conclude that blood coagulation is initiated by long-term expression of tissue factor and rapid massive alterations in cellular membranes. This was confirmed by the detection of the turned phospholipids mesophases in tissue thromboplastin preparations and heterogeneity of vitamin К-depending factors binding. Based on the results of the research, a functional conception of blood coagulation initiation by phase alteration of bilayer structure of cellular membranes to a mesomorphic structure was developed. It is caused by different agonists through receptor dependant Са 2+-mobilizing cell signal systems or by massive migration of calcium ions into the cell at its damage. An initial bioimitating non-enzymatic proteolysis vitamin of К-dependant factors and their massive enzymatic activating in the ensembles of enzymatic complexes takes place on heterophase phospholipids surface. Clotting is limited by blood and tissue macrophages, removing cells and phospholipids particles with heterophase surface from cell circulation, and also by anticoagulant factors action. Based on this conception, the researches revealed the pathogenetic of role thrombogenic micro vesicles originating form the cellular membranes transformation in the development of disseminated intravascular coagulation syndrome, myocardial infarction, leucosis, autoimmune and infectious diseases. Finding out the basic concepts of blood coagulation initiation mechanism puts D.M. Zubairov in one row with scientists, pawning the bases of modern biology and medicine.
Kazan medical journal. 2013;94(5):755-760
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Influence of iron sulfate on adipose tissue endocrine dysfunction in Wistar rats
Tinkov A.A., Popova E.V., Nikonorov A.A.
Abstract
Aim. To study the adipose tissue endocrine function at adipogenic effect development in Wistar rats on high-fat diet and increased iron intake with drinking water. Methods. Animals on standard and high-fat diets were administered 3 mg/l of iron sulfate with drinking water during 3 months. Levels of circulating proinflammatory cytokines (monocyte chemoattractant protein 1, tumor necrosis factor alpha), leptin, adiponectin, serum glucose and insulin, as well as morphometric parameters and iron content in hair and adipose tissue were evaluated. Results. A significant increase in morphometric parameters, hair iron levels was observed in rats taking iron salts compared to the controls, with highest adipose tissue iron level in rats on high-fat diet. At the same time, serum levels of proinflammatory cytokines (monocyte chemoattractant protein 1, tumor necrosis factor alpha) and leptin was also higher in rats obtaining iron with drinking water compared to controls. Increased serum insulin level together with slightly elevated serum glucose level indicated insulin resistance development in rats on high-fat diet, fed with iron. Conclusion. The research shows that, on the one side, iron intake potentiates the adipogenic effect of high-fat diet, and on the other side, acting as a trigger for endocrine dysfunction formation (so called endocrine disruptor).
Kazan medical journal. 2013;94(5):760-763
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The rationale for the post-transfusion reactions prevention program in rh-positive patients
Turaev R.G., Bel’skaya E.E.
Abstract
A case of a patient with А 2В (IV) Rh 0(D) + blood group, CcDEeK - phenotype, in whom anti-erythrocyte antibodies (+) were found and specified as anti-D antibodies, is presented. The Rh compatibility tests were positive with 28% Rh 0(D) +-donors (incompatibility) and negative with all Rh 0(D) --donors (compatibility) as well as with own erythrocytes (compatibility). The case indicates that a timely extensive examination of a patient’s blood (antigen profile examination with anti-erythrocyte antibodies detection) before blood transfusion guarantees the blood transfusion safety and reduces the rate of negative consequences of erythrocyte-containing blood components, including hemolytic reactions.
Kazan medical journal. 2013;94(5):764-765
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The features of mucosal immunity and microbiota at different forms of allergic rhinitis
Tyurin Y.A., Shapkina E.I., Mustafin I.G., Fassakhov R.S.
Abstract
Aim. To assess the parameters of local immune response in patients with different forms of allergic rhinitis, associated with nasal bacterial infection. Methods. Nasal swabs and nasal epithelium samples obtained from 10 patients with seasonal allergic rhinitis aged 12 to 32 years and from 15 patients with persistent allergic rhinitis aged 18 to 45 years, as well as form the 20 healthy subjects aged 18 to 45 years without signs of allergy who were age and gender-comparable, were examined. Swabs were prepared from cell suspension, stained with 0.04% trypan blue solution, and a microscopy with the count of non-stained cells was performed. Epitheliocytes expressing toll-like receptors-2, were determined by flow cytometry. Interleukin-10 concentration in swabs was assessed by ELISA. Results. The number of epitheliocytes expressing toll-like receptors-2 was by 1.9 times lower in patients with seasonal allergic rhinitis and by 1.7 times lower in patients with persistent allergic rhinitis compared to control group. There was a reverse correlation found between the number of epitheliocytes expressing toll-like receptors-2 and interleukin-10 level in nasal swabs of healthy controls, while in patients with allergic rhinitis a it was a direct correlation. In patients with persistent allergic rhinitis S. aureus was a part of microbiota in 100% of cases and was associated with other bacteria (Str. pyogenes - 33.3%, Neisseria spp. - 66.7%). In patients with seasonal allergic rhinitis the association of S. aureus and S. hemolyticus (70.0%) was the most frequent one. In the control group, S. epidermidis (50.0%), Str. viridians (25.0%), S. hominis (25.0%) were among the nasal microbiota. There were no differences revealed between the mean levels of interleukin-10 in patients with allergic rhinitis and healthy controls. Conclusion. The number of epitheliocytes expressing toll-like receptors-2 was significantly reduced by almost 2 times in patients with persistent allergic rhinitis compared to control group. Colonization of nasal mucosa by S. aureus in patients with allergic rhinitis leads to an increase of epithelial cells expressing toll-like receptors-2.
Kazan medical journal. 2013;94(5):766-770
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Pilot cross-sectional study for potential fibrogenic risk assessment in real multiwalled carbon nanotube aerosol exposure at the workplaces
Fatkhutdinova L.M., Khaliullin T.O., Vasilyeva O.L., Zalyalov R.R., Valeeva I.K., Mustafin I.G., Shvedova A.A.
Abstract
Aim. To assess the potential fibrogenic risk of real occupational exposure to multi-walled carbon nanotubes (MWCNT). Methods. The study was conducted at 2 MWCNT-producing enterprises with the same reactor type. 11 employees who had more than 1 year-long contact with MWCNT aerosol were included in the exposure group, the control group consisted of 14 people. Elemental carbon level and MWCNT presence were evaluated in workplace air samples by transmission electron microscopy. Blood and induced sputum samples were obtained from employees, transforming growth factor beta 1 (TGFβ 1), KL-6 glycoprotein and osteopontin levels were evaluated. To assess the relationship between MWCNT exposure and biomarker levels (age, gender, smoking were chosen as cofounders), generalized linear models including main effects and paired interactions were created. The regression coefficients confidence intervals were refined by bootstrap analysis. Results. Time-weighted average respirable MWCNT fraction was up to 6.11 mg/m 3. Transmission electron microscopy showed the presence of MWCNT agglomerates sized 0.5-10 μm in all air samples. The levels of TGFβ 1 in serum were significantly dependent on exposure to MWCNTs (b=10.47, 95% BCa=1.18-51.75), the KL-6 glycoprotein levels in induced sputum was significantly higher in exposure group (b=235.9, 95% BCa=21.2-482) compared to control group. Osteopontin did not prove itself as an informative indicator. Conclusion. Gained data suggest that MWCNT aerosol exposure at workplace may lead to fibrogenic biomarkers level changes in serum and induced sputum samples. Control measures for MWCNT aerosol levels and medical surveillance for employees should be introduced in MWCNT-producing and applying facilities.
Kazan medical journal. 2013;94(5):770-774
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Lymphocyte apoptosis in newborns with neonatal sepsis
Khaertynov K.S., Boychuk S.V., Anokhin V.A., Dunaev P.D., Ramazanov B.R., Satrutdinov M.A., Agafonova E.A.
Abstract
Aim. To assess the lymphocyte apoptosis intensity in children with neonatal sepsis. Methods. Lymphocyte apoptosis was assessed in 20 children [of them 16 (80%) prematurely born] with late neonatal sepsis. Bacteriology tests allowed to identify the causetive agent for sepsis in 9 (45%) cases - Staphylococcus haemolyticus in 3 cases, Klebsiella - in 4 cases, Candida - in 2 cases. The control group consisted of 10 healthy newborns. Lymphocyte apoptosis was assessed by determining the amount of mitochondrial transmembrane potential (ΔΨm). Lymphocytes were stained with fluorochrome DiOC 6. Results were obtained by flow cytometry. A decrease in mitochondrial potential value was defined as the reduction of fluorochrome DiOC 6 fluorescence . This parameter is one of the earliest signs of apoptosis. Results. An increased apoptosis was revealed, which was manifested by an increase in the number of cells with reduced membrane potential (DiOC-negative cells) in all children with neonatal sepsis. In 50% of sepsis cases (10 newborns) the number of lymphocytes in which apoptosis was triggered was higher by 3,4 times compared to control, in 25% of cases (5 newborns) - by 6 times, in another 25% (5 newborns) - by 13.4 times. Meanwhile, an absolute lymphopenia was observed only in 65% of cases. The most extensive apoptosis was observed in patients with minimal intensity of severe acute inflammatory reaction. Recovery period was characterized by a decrease in apoptosis intensity, seen as the reduction of the number of cells with reduced membrane potential by mean of 1.9 times. Reduced intensity of lymphocyte apoptosis at recovery was associated with lymphocyte count increase in peripheral blood. Conclusion. Acute phase of neonatal sepsis occurs on the background of the increased intensity of lymphocyte apoptosis.
Kazan medical journal. 2013;94(5):775-778
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Features of oxidative stress in patients with delirium tremens infected with hepatitis C and human immunodeficiency virus
Tseilikman V.E., Babin K.A., Vinogradov D.B., Shatrova Y.M., Izarovsky B.V., Manukhina E.B., Downey H.F., Tseilikman O.B., Mingazov A.K.
Abstract
Aim. To determine the impact of concomitant viral infection on oxidative stress features in patients with delirium tremens. Methods. 110 male patients of working age (23-55 years) with a diagnosis of «delirium tremens» were included, of which 28 patients had with concomitant hepatitis C virus (HCV) infection, 18 patients - concomitant human immunodeficiency virus (HIV) infection, 44 patients had delirium tremens without any concomitant viral infections. An HCV and HIV co-infection was diagnosed in 20 patients with delirium tremens. Lipid peroxidation products and carbonylated proteins blood levels were examined in all patient groups. Results. Signs of cytolysis (elevated levels of transaminases and signs of oxidative stress that manifested as an increase of саrbonilated proteins levels compared to control) were revealed in all groups. However, the study groups varied in severity of both cytolysis and oxidative stress. The most marked increase in transaminases and carbonylated proteins levels was characteristic for patients infected with HCV and HIV, but with no history of increased alcohol consumption. Also, lipid peroxidation molecular products levels were decreased in these groups. In patients with delirium tremens, as well as in alcoholics infected with HCV and HIV, like in patients with no history of increased alcohol consumption infected with HCV and HIV, oxidative stress manifested only in enhancing protein carbonylation. Conclusion. Concomitant viral infection affects the extent of oxidative stress and hepatic dysfunction in patients with delirium tremens.
Kazan medical journal. 2013;94(5):778-781
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