[THE IDENTIFICATION OF ALTERATIONS IN THE AREA OF GREAT DUODENAL PAPILLA AND MICRO-CHOLELITHIASIS AS A TECHNIQUE OF PREVENTION OF POST-CHOLECYSTECTOMY SYNDROME AFTER MINI-INVASIVE CHOLECYSTECTOMY].

The article presents the results of endoscopic and laboratory analyses of bile in 90 patients after mini-invasive cholecystectomy The significant amount of endoscopic diagnosed alterations in the area of major duodenal papilla that amounted to 64.4% of examined patients and also occurrence of micro-cholelithiasis and insoluble precipitates in analyzed bile of 83.3% of patients. The derived data testifies necessity of application of pre-operational endoscopic diagnostic of alterations in the area of major duodenal papilla and in post-operative period as well completing it by analysis of native bile preparation.

[Acute inflammation phase reactants and interleukin-8 in myocardial infarction].

The study was undertaken to search for additional diagnostic criteria allowing the depth of myocardial damage to be estimated in males aged 57.2 +/- 9.6 years. Few interrelated acute phase reaction indices, including the levels of interleukin-8 (IL-8), lactoferrin (LF), alpha2-macroglobulin (alpha2-MG), plasmin (PL) and alpha2-MG-PL circulating complexes, were studied in serum on days 1, 7, and 17 of the onset of the disease. In small-focal myocardial infarction, the levels of alpha2-MG and PL were decreased on day 1 and those of LF and IL-8 were increased on day 14. On the contrary, in large-focal myocardial infarction, the concentrations of IL-8 and LF rose just on day 1 while those of alpha2-MG and PL remained unchanged. The detected differences may be used as additional criteria in differential diagnosis, particularly when ECG was of no informative value. Further, the concurrent elevation of alpha2-MG, PL, and PL-alpha2MG concentrations in large-focal myocardial infarction is indicative of poor prognosis.

[Cytokine and acute phase inflammation reactant levels in men with myocardial infarction].

The role of cytokines, their putative transporters, and other acute phase reactants was studied in 17 men aged 57.2 +/- 9.6 yr with microfocal myocardial infarction (MI) and in 21 ones with macrofocal MI. Control group comprised 30 age-matched men. Diagnosis of MI was confirmed by traditional functional tests and laboratory methods. It was shown that levels of TNF-alpha and MG-PL transport complexes were elevated regardless of MI type whereas acute phase reactants increased only in patients with macrofocal MI These patients also had enhanced IL-6 and IL-8 levels with gradual normalization of the former. In microfocal IM, IL-8 increased only by day 14. Inhibitory action of TNF-alpha appears to be insufficient to suppress effect of macrofocal IM but may be responsible for its selective effect on acute phase reactants. The above differences can be used as additional criteria for differential diagnosis of micro- and macrofocal MI especially in patients with repeated MI or His bundle block when traditional ECG data are of poor informative value.

[Some proteins of acute phase of inflammation in differential diagnostics of rheumatoid arthritis].

Levels of lactoferrin (LF), antithrombin-III (AT-III) and beta2-macroglobulin (MG) in blood of patients with rheumatoid arthritis (RA), reactive arthritis (ReA) and systemic lupus erythematosus (SLE) were examined for assessment their importance in differential diagnostics of the diseases. It was shown that on the average, LF and AT-III levels were increased at RA, while MG level was practically unchanged. At the same time LF level was stable high regardless of RA activity and duration degree, but its concentration was significantly increased also in ReA patients (33% patients). AT-III, on the contrary, depended on process activity and duration, was more specific to RA, than LF, but its sensitivity at RA was not enough high (from 25 to 44% patients with increased levels subject to disease duration and activity). Coefficient LFE/AT-III, obtained by multiplication of these proteins concentration, had the greatest diagnostic value. Its sensitivity at RA is on the average 85%, and specificity at differential diagnostics of RA--80% vs. ReA and 92% vs. SLE. We consider that coefficient LFbetaAT-III can be used as an additional criterion at differential diagnostics at RA early stages, while other specific antibodies cannot be detected yet.

[The serum levels of inflammatory reactants in women with inflammatory diseases of the uterine appendages, who participate in the in-vitro fertilization].

The blood concentrations of various inflammatory reactants were studied in female participants of the in-vitro fertilization (IVF) programs depending on the outcome. Comparison of the obtained values with the values characteristic of healthy women and with the levels of the above reactants in patients with subacute inflammatory diseases of the uterine appendages indicated that females with IVF failures had elevated levels of lactoferrin and circulating alpha2-macroglobulin-IgG complexes and decreased concentrations of IgG as in women with a localized pyodestructive process in the appendages, but in women having effective IVF, the levels of the study proteins did not differ from those in healthy donors. The authors recommend that the above indices should be used as criteria substantiating the need for additional sanitation and anti-inflammatory therapy before initiating the IVF program.

[Hormones, cytokines and macroglobulines in blood of women with autoimmune thyroid diseases].

AIM: To study proportions of hormones, cytokines and macroglobulins in autoimmune thyroid diseases. MATERIAL AND METHODS: Participants of the study were 28 females aged 43 +/- 5 years with diffuse toxic goiter (DTG), 31 females aged 41 +/- 6 years with autoimmune thyroiditis (AIT) and 26 controls (n = 26) free of thyroid pathology aged 40 +/- 4 years. DTG and AIT diagnoses were confirmed by ultrasound and laboratory examinations. RESULTS: Both autoimmune diseases were accompanied by a significant rise of serum IL-6 and fall of TNF-alpha levels vs those in the controls. In AIT interferon-gamma was higher than in DTG while in DTG alpha-2-macroglobulin rose higher but TNF-alpha reduced more than in AIT. CONCLUSION: It is suggested that an elevated level of interferon-gamma in AIT contributes to blockade of endocytosis of peptid hormones and cytokines transported by macroglobulins. Overproduction of IL-6 in DTG may be caused by deficiency of its antagonist--TNF-gamma leading to an increase in macroglobulin concentration, its gene inductor is the above interleukin.

[Evaluation of the function of the hematoencephalic barrier in victims with craniocerebral trauma in critical state]. / Otsenka funktsii gematoéntsefalicheskogo bar'era pri kriticheskikh sostoianiiakh u postradavshikh s cherepno-mozgovoi travmoi.

Estimates of the relative-entry coefficient, molecular profile of the cerebrospinal fluid and of the molecular blood profile based on the comparison of concentrations of proteins with different physical-and-chemical properties enable an evaluation of the function of the hematoencephalic barrier in victims with craniocerebral trauma in critical state. It was possible to state, with such approach in use, that the regulatory and protective functions of the hematoencephalic barrier were changing differently in favorable and unfavorable trauma outcomes, which must be duly considered in choosing a treatment tactics for the above category of victims.

[Complex assessment of inhacort effectiveness in bronchial asthma]. / Kompleksnaia otsenka éffektivnosti ingakorta pri lechenii bol'nykh bronkhial'noi astmoi.

AIM: To investigate efficiency of inhacort in long-term (6 months to 2 years) treatment of bronchial asthma (BA). MATERIALS AND METHODS: 67 inpatients and 65 outpatients with moderate BA were divided into two groups. 96 patients of group 1 had received standard combined treatment without glucocorticosteroids (GCS), 36 patients of group 2 had received GCS. Inpatients were given inhacort in a dose 1000 micrograms/day, outpatients took inhacort in a daily dose 500 micrograms/day. The examination scheme included assessment of external respiration function (ERF), blood hydrocortisone, sputum rheology and diagnosis of candidosis. RESULTS: Inhacort treatment has reduced frequency of asphyxia attacks 2.5-fold 30 and 25% of the patients stopped taking sympathomimetics and GCS, respectively. None of the patients had asphyxia as a status. ERF, sputum viscosity improved, hydrocortisone secretion was unchanged. Only 3.8% of the patients developed oral candidosis. CONCLUSION: Inhacort in a dose 1 mg controls BA. 73% of the patients treated outpatiently had no need in hospitalization.

Effect of human alpha2-macroglobulin on proliferative activity of rat tumor cells. / Vliianie alpha2-makroglobulina cheloveka na proliferativnuiu opukholevykh kletok krys]

The Walker carcinosarcoma cells were cultured in the medium with low concentration (0.25%) of fetal calf serum, in the presence of native or methylamine-treated (modified) human alpha 2-macroglobulin (alpha 2-MG) in vitro. The proliferative activity (3H-thymidine incorporation) of these cells increased in the presence of one or the other alpha 2-MG preparation. It allows to suppose that the human alpha 2-MG may serve as a growth-stimulating factor of tumour cells.

[Immunoenzyme method of lactoferrin analysis]. / Immunofermentnyi metod opredeleniia laktoferrina.

The authors propose a highly effective method for isolation of lactoferrin from female colostrum. Lactoferrin is measured by the sandwich enzyme immunoassay. Its concentrations in the serum, urine, amniotic and cerebrospinal fluid in health are measured. The advantages of the method for lactoferrin purification and the practical significance of this protein are discussed.

[A complex evaluation of the efficacy of aldecin in treating bronchial asthma patients]. / Kompleksnaia otsenka éffektivnosti al'detsina pri lechenii bol'nykh bronkhial'noi astmoi.

AIM: Study of efficiency of inhalation glucocorticosteroid Aldecine. MATERIALS AND METHODS: A 4-week trial of 30 patients with bronchial asthma. Treatment results were evaluated by clinical symptoms, demand of inhalation sympathomimetics, external respiration, viscosity and elasticity of bronchial secretion, concentrations of hydrocortisone and thyroid hormones. RESULTS: Aldecine produced a good clinical effect, improved external respiration, allowed to reduce doses of inhalation beta-adrenomimetics. No deterioration of either bronchial secretion rheology or inhibition of adrenal and thyroid function was seen. Candidiasis was clinically negligible. CONCLUSION: Aldecine proved highly effective and tolerable in patients with bronchial asthma.

[The effect of salben on the rheological properties of the bronchial secretion]. / Vliianie sal'bena na reologicheskie svoistva bronkhial'nogo sekreta.

AIM: Assessment of the effect of a new Russian selective sympathomimetic salben (powder for inhalations) on bronchial secretion viscosity and adhesion. MATERIALS AND METHODS: Salben or placebo (sodium bensoate) were given to 82 and 30 patients (control) with bronchial asthma, respectively. The response was assessed by clinical, laboratory and instrumental findings. RESULTS: A statistically significant (p < 0.05) reduction of the viscosity and adhesion (by 15 and 20%, respectively) was noted in the salben group which also demonstrated improved external respiration. CONCLUSION: Salben induced positive effect on bronchial secretion viscosity and adhesion.

[A comparative study of alpha2-macroglobulin and pregnancy-associated alpha2-glycoprotein and protein A as possible analogs]. / Sravnitel'noe izuchenie alpha2-makroglobulina i assotsiirovannykh s beremennost'iu alpha2-glikoproteina i proteina A kak vozmozhnykh analogov.

Pregnancy-dependent protein A, alpha 2-glycoprotein as well as alpha 2-macroglobulin were isolated from retroplacental blood serum by means of affinity chromatography. These proteins proved to be similar in their structure, amino acid and carbohydrate compositions as well as in their properties to bind proteinases and to inhibit the enzymatic activity. The hypothesis on possible integration of these proteins into a group of high molecular inhibitors of proteinases is discussed.