[Living related liver transplantation in the Republic of Uzbekistan: current status and development prospects]. / Rodstvennaya transplantatsiya pecheni v Respublike Uzbekistan: nyneshnee sostoyanie i perspektivy razvitiya.

OBJECTIVE: To analyze primary results of living related liver transplantation in the Republic of Uzbekistan. MATERIAL AND METHODS: There were 44 living related transplantations of the right liver lobe in patients with decompensated liver failure between February 2018 and February 2023. RESULTS: Uneventful postoperative period was observed in 17 (38.6%) recipients. Other 27 patients (61.4%) developed 47 various postoperative complications (1-3 events per a patient). Of these, 8 (18.2%) patients required early postoperative re-laparotomy. Among 44 patients, 9 (20.5%) ones died in early postoperative period, and one patient died in long-term period (3 years after transplantation) from chronic rejection under refusal to take immunosuppressive drugs. Early satisfactory results were obtained in 79.5% of patients, long-term favorable outcomes - in 77.3% of cases. CONCLUSION: Engraftment rates and survival of recipients to a large extent depend on surgical strategy, baseline disease and clinical severity. The so-called "center effect" is essential at initial stages of implementation of the program.

[Predictors of postoperative complications in patients with ventral hernia]. / Prediktory posleoperatsionnykh oslozhnenii u patsientov s ventral'nymi gryzhami.

OBJECTIVE: To evaluate potential predictors of 1-month postoperative complications after primary ventral hernia repair using database of the 1st Clinic of the Samarkand State Medical University. MATERIAL AND METHODS: A cohort study included 348 patients who underwent ventral hernia surgery in the 1st Clinic of the Samarkand State Medical University between January 1, 2014 and January 1, 2021. We performed logistic regression analysis to identify risk factors of postoperative complications. RESULTS: More than one complication within 1-month after surgery developed in 87 (25%) patients. Those factors associated with complications in univariate analysis (p<0.05) and clinically important factors were included in multivariate analysis. In multivariate analysis, age, body mass index, hypertension, hernia size, hospital-stay and surgery time were independent risk factors. CONCLUSION: Age, BMI, hypertension, anamnesis and size of hernia, as well as surgery time correlated with postoperative complications. Therefore, these factors should be used in preoperative risk assessment.

Assessment of the quality of anti-tuberculosis medicines in Almaty, Kazakhstan, 2014.

SETTING: In 2009, the World Health Organization (WHO) conducted a survey of the quality of four anti-tuberculosis drugs in the former Soviet Union countries. Kazakhstan had the highest proportion of substandard drugs. OBJECTIVE: To assess the quality of anti-tuberculosis drugs used in Kazakhstan in 2014. DESIGN: Fourteen anti-tuberculosis drugs from the Almaty Interdistrict TB Dispensary were randomly selected and screened for quality using Global Pharma Health Fund Minilab™ testing. First, the product and packaging were physically inspected to determine whether tablets/capsules were intact (i.e., whether they contained the full amount of the drug, and whether the packaging was genuine). Second, the tablets/capsules were dissolved in water to test whether they could be adequately absorbed by the body. Finally, semi-quantitive analyses were undertaken using thin-layer chromatography to verify the presence and concentration of the active pharmaceutical ingredient and to detect impurities. RESULTS: We discovered no counterfeit medicines. However, 163 (19%) of the 854 anti-tuberculosis drugs sampled failed at least one of the three tests. These samples were found among 24/50 (48%) batches of 14 anti-tuberculosis drugs. CONCLUSION: Our study identified a high proportion of poor-quality first- and second-line anti-tuberculosis drugs. Use of these medicines may lead to treatment failure and the development of drug resistance. Confirmatory testing should be performed to determine if they should be removed from the market.

[Problems of registration of morbidity and ways of its improvement].

New system of registration of primary morbidity was developed for the purpose of elimination of systemic error factors and decrease of human element input. The following principles are included: simplification of registration rules; more exact registration of acute conditions; unified rules of registration for out-patient and in-patient medical institutions; unified form of information fields in medical documentation for morbidity registration in out-patient and in-patient medical institutions; succession in basic parameters, indicators and terms of medical statistics in currently in force and modernized systems. New system includes following information fields: "stage of diagnostics", "urgency of condition"; "ICD-10 code", "diagnosis", "life identification", "calendar year identification". All fields, except field "diagnosis", are formalized and for them (except field "ICD-10 code") corresponding codings are developed. Rules for filling information fields, algorithms of validity control of primary information and receiving such indicators as first time identified morbidity", "chronic morbidity", "emergency (acute) morbidity", "chronic sickliness/morbidity identified for the first time in previous years", "chronic sickliness" are developed. This system is implemented experimentally in medical institutions of primary and secondary levels of health care system in Yakka-Saraysk district of City of Tashkent.

Postoperative calcitonin study in medullary thyroid carcinoma.

Calcitonin (CT) is a sensitive marker for medullary thyroid carcinoma. Normalization of early postoperative CT level is a favorable prognostic factor. The aim of this study was to establish the prognostic value of CT-level kinetics by preoperative tumor stage and postoperative elimination rate. Blood serum from 22 medullary thyroid carcinoma (MTC) patients without remote metastases was assayed. A commercial RIA DSL-1200 test was used to assay CT levels. Basal CT< or =42 pg/ml and stimulated CT< or =120 pg/ml were considered normal. The patients were divided into three groups according to the intensity of the postoperative CT level reduction in blood serum. Group 1 comprised patients who showed basal CT normalization within the first 2-3 days after surgery. Group 2 included those patients with slow (from 2 to 4 weeks) CT-level normalization. Group 3 included patients with CT levels that reduced within 14 days, but subsequently increased. Preoperative basal CT varies from 216 to 1654 pg/ml and depends on tumor-node-metastasis (TNM) stage. In seven patients, no basal CT decrease to normal values was observed; in five of these patients, disease recurrence was detected 2-6 months after surgery. In the group with slowly decreasing CT levels, no strong correlation between preoperative CT level and the postoperative time to normalization of basal and peak CT could be established; this may be due to the small number of patients. Our study showed that preoperative CT level depended on the disease stage. Postoperative CT elimination rate is independent of preoperative CT level. Postoperative increase in the basal or stimulated CT level is an unfavorable prognostic factor, implying disease recurrence.

[Comparative characteristics of diagnostic methods of primary hyperparathyroidism in patients with urolithiasis]. / Sravnitel'naia kharakteristika metodov diagnostiki pervichnogo giperparatireoza u bol'nykh mochekamennoi bolezn'iu.

Nephrolithiasis (NL) is a frequent complication of hyperparathyroidism (HPT). Such patients account for 5% of those with nephrolithogenesis. The study included 89 HPT patients (age 34.8 +/- 1.9 years) with NL, 22 patients (age 38 +/- 1.4 years) with NL and 10 healthy controls (age 30 +/- 1.2 years). Hypercalciemia was seen in 27-20% of patients with HPT and NL, 9-10% of patients with nephrolithiasis. Evaluation of parathyroid hormone (PTH) levels in the blood of the examinees showed its high diagnostic value: in 89% of HPT patients this level was high. It was also elevated in 10% of NL patients. cAMP in HPT and NL was elevated in 68.48 and 12% of patients, respectively, serum concentration of Ca2+ was high in 81.4 and 24.5%, Ca load test was positive in 80.9 and 10% of the patients, respectively. It is important for diagnosis that in HPT bone mass is low.

[Glucose tolerance disorders in patients with hypothyroidism]. / O narusheniiakh tolerantnosti k gliukoze u bol'nykh gipotireozom.

Altogether 42 patients with hypothyrosis of different etiology (aged 17 to 57) were investigated. According to the results of oral glucose tolerance test (OGTT) all the patients were divided into 3 groups: normal OGTT, disturbed OGTT and a flat type of glycemic curves. High levels of cortisol and free fatty acids (FFA) were detected in persons with disturbed OGTT. A lowered reaction to insulin was found in 15 patients with high levels of cortisol and FFA. Persons with unchanged sensitivity to insulin demonstrated a normal type of OGTT and normal blood levels of cortisol and FFA, and among patients with a low reaction to insulin there were persons with disturbed OGTT and high blood levels of cortisol and OGTT. Positive correlation was found between OGTT disturbances, on the one hand, and lowered sensitivity to insulin, increased blood levels of cortisol and FFA, on the other hand. A conclusion has been made that one of the causes of GTT disturbance in patients with hypothyrosis is an increase in the blood levels of cortisol and FFA and a decrease of sensitivity to insulin.

[The effect of cryopreservation and transplantation factors on the morphofunctional state of the thyroid in dogs]. / Vliianie kriokonservatsii i faktorov transplantatsii na morfofunktsional'noe sostoianie shchitovidnoi zhelezy sobak.

Influence of transplantation of non-specific factors (denervation, delymphatization, surgical trauma, ischemia, changes in blood supply conditions) as well as the effect of cryopreservation (-196 degrees C) on morphological structure and ability for secretion of thyroid hormones and response to TS stimulation were studied using the model of extracorporal biological perfusion in isolated thyroid of dogs. The results of biochemical and morphological investigations of thyroid in different conditions of perfusion showed, that it had preserved its main functional and morphological characteristics under the action of transplantation of nonspecific factors and extremely low temperatures.

[Changes in the ratio of secreted thyroid hormones under the action of adrenaline, propranolol and thyrotropic hormone]. / Izmenenie sootnosheniia sekretiruemykh tireoidnykh gormonov pod deistviem adrenalina, propranolola i tireotropnogo gormona.

The injection of 0.5 mM of adrenalin and 3.3 X 10(-3) M of propranolol in the thyroid artery of the thyroid lobe perfused in a thermostatic chamber (37 degrees C) 1h after the beginning of perfusion caused a decrease in the index of thyroid deiodination by 48 and 37%, respectively. Adrenalin injection 2 h after TSH lowered the stimulating effect of the latter on thyroxine thyroid conversion. A conclusion is made that adrenalin testing can suppress the activity of thyroid conversion of T4 into T3 and decrease the activity of TSH-stimulated deiodination.

[Extracorporeal biological perfusion of isolated canine thyroid glands]. / Ekstrakorporal'naia biologicheskaia perfuziia isolirovannoi shchitovidnoi zhelezy sobak.

A model of extracorporeal biological perfusion of the isolated thyroid gland in dogs has been developed. The experiments on dogs were performed to analyse the functional state of the perfused gland. It has been shown that the functional state parameters in 6-hour perfusion were comparable to the control values. It is concluded that the model suggested creates physiologic conditions and can be employed as a model for studying the influence of various factors on the isolated thyroid gland, as well as for investigating problems related to thyroid gland transplantation.

[Intrathyroid deiodination of thyroxine: the effect of thyrotropic hormone and denervation of the thyroid]. / Vnutritireoidnoe deiodirovanie tiroksina: vliianie tireotropnogo gormona i denervatsii shchitovidnoi zhelezy.

Intrathyroid transformation of thyroxin (T4) into triiodothyronine (T3) and the role of thyrotropic hormone and denervation in this process were studied with in vivo blood perfusion of dog thyroid gland in situ and at 37 degrees C. Both labelled 125I-T4 (200,000 imp/min) and nonlabeled T4 (1000 ng) were administrated in the arteries of thyroid lobules in situ and in a constant-temperature cabinet. Enhanced excretion of triiodothyronine (both labeled and nonlabeled) observed two hours after the injection in the thyroid blood output was suggested as an evidence of denervation-independent deiodination occurring in the thyroid tissue. Without T4 load the proportion of T3 in the thyroid venous blood was significantly increasing under the thyroid denervation thus attesting inhibitory effect of nervous impulse on T4 deiodination in the thyroid gland. TTH being administrated into thyroid arteries in a dose of 20 I.U. produced a pronounced elevation of T4 thyroid conversion in T3 which was less manifest in the process of denervation thus evidencing the high sensitivity of the process to TTH.

[Dynamics of various indicators of cellular immunity in patients with diffuse toxic goiter after drug therapy]. / Dinamika nekotorykh pokazatelei kletochnogo immuniteta u bol'nykh diffuznym toksicheskim zobom pod vliianiem medikamentoznoi terapii.

The purpose of the investigation was to study some indices of the immune system of patients with diffuse toxic goiter (DTG) before multimodality thyrostatic therapy and after achieving clinical remission. A total of 30 DTG patients with an average severity of disease were examined. The immune status was evaluated according to the content of T-lymphocytes, T-suppressors, Fc gamma-lymphocytes and antigen-binding lymphocytes (ABL) responsive to thyroglobulin. Conservative therapy included mercazolyl, beta-adrenergic blockers, sedative and cardiac drugs. A drop of T1T gamma and Fc gamma-lymphocytes was revealed in the period of the manifestation of the clinical signs of disease. The indices of ABL responsive to thyroglobulin significantly exceeded the relative and absolute indices of the control group. Multimodality drug therapy resulted in the deepening of T-lymphocyte deficiency, a significant rise of T gamma 1 and T gamma 2 as compared to the initial levels. A tendency to a decrease in the level of Fc gamma-lumphocytes was noted after the therapy. The relative and absolute values of the ABL indices significantly decreased, however a significant increase in these indices compared to the control ones maintained.

[Effect of cryopreservation of thyroid parenchyma on iodoamino acid composition of thyroglobulin and its iodination]. / Vliianie kriokonservatsii tireoidnoi parenkhimy na iodaminokislotnyi sostav tireoglobulina i ego iodirovanie.

The content and distribution of iodoamino acids in thyroglobulin of the cryopreserved thyrotoxically-changed thyroid parenchyma were studied, as was thyroglobulin iodination. Thyroid tissue obtained during operations of patients with diffuse-toxic goiter was investigated. The thyroid parenchyma was cryopreserved according to the method developed at the Institute of Cryobiology and Cryomedicine Problems, Academy of Sciences of the Ukrainian SSR. The tissues were stored for 4-6 months. Thyroglobulin was isolated by gel filtration of the thyroid saline extract through a column packed with Sephadex G-200. Thyroglobulin was iodinated with KI + I2 water solution, pH 9.2, at 37 C for 30 min. The amount of iodine added was 100 moles of I2 per protein mole. Protein concentration was determined by the biuret reaction. Thyroglobulin iodoamino acid composition was determined by direct spectrophotometry. Absorption spectra were measured by an EPS-3T recording spectrophotometer ("Hitachi", Japan). The processes of freezing (-196 degrees C) and thawing of the thyroid parenchyma were shown to induce no changes in the thyroglobulin iodoamino acid composition. Cryopreservation of the thyroid parenchyma considerably affected iodine incorporation and formation of iodoamino acids in the thyroglobulin during its in vitro iodination. It may be supposed that cryopreservation of the thyroid tissue affects the thyroglobulin conformational status, that results in increased iodination of this iodoprotein.