[Contemporary data on efficacy of anticoagulant therapy in recanalization of deep veins]. / Sovremennye dannye ob éffektivnosti antikoaguliantnoi terapii pri rekanalizatsii glubokikh ven.

The article is a literature review containing a detailed description of anticoagulant therapy variants, their efficacy in recanalization of deep veins, as well as patients' compliance to treatment. Russian specialists have demonstrated that the processes of active re-organization of thrombotic masses, in some cases leading to complete clearing of the vessel's lumen from a thrombus, may be observed at terms from 3 to 6 months, with a failure to occur within the above period reportedly followed by formation of irreversible cicatricial-sclerotic alterations in the veins. That is why adequate anticoagulant therapy should be initiated promptly in order to prevent the development of irreversible alterations and a decompensated form of chronic venous insufficiency. The process of recanalization of the venous segments involved appears to primarily depend on efficacy of anticoagulant therapy. Of special attention is a class of novel oral anticoagulants characterised by high clinical efficacy, prolonged and relatively safe administration, as well as thrombolytic activity. The use of anticoagulant therapy, as well as adherence of patients to treatment make it possible to significantly decrease the frequency of a decompensated form of venous insufficiency and the need for reconstruction of the major veins.

Infradian Rhythm of the Content of Secretory Granules in Pinealocyte Cytoplasm in Mice and Rats.

The numerical density of secretory granules dense-core vesicles (DCV) in the cytoplasm of pinealocytes of the pineal gland was estimated by transmission electron microscopy in male white mice and Wistar rats. The 3-day biorhythm and lunaphase changes in the DCV content in the perikaryon and the processes of pinealocytes, which are manifested significantly in different seasons of the year, are established. The three-day biorhythm in adult male mice in comparison with younger male rats is not expressed uniformly in different phases of the moon. The in-phase manifestation of infradian biorhythms in different species of animals during the year with an unchanged daily photophase indicates the existence of common external synchronizers for mammals of these biorhythms that are not associated with the light/dark cycle.

[Experience in treating portal thromboses in patients with chronic myeloproliferative diseases].

Patients with myeloproliferative diseases (MPD) are noted to be at high risk for portal thromboses. This problem gives rise to disability if it is untimely treated or resistant to therapy. The paper gives the experience of the Outpatient Department of the Hematology Research Center, Ministry of Health of the Russian Federation, in using antithrombin III in MPD patients (3 patients with primary myelofibrosis, 3 with essential thrombocythemia) and acute and subacute portal vein thromboses resistant to therapy with direct anticoagulants. In all 5 cases, the use of antithrombin III in combination with low-molecular-weight heparin showed a positive clinical effect as rapid relief of pain syndrome and comparatively early (3-week to 1.5-2-month) recanalization of thrombosed vessels. Three clinical cases are described in detail.

[The combined rehabilitative treatment of the children with obesity and metabolic syndrome].

The present study included a total of 66 children at the age from 11 to 16 years with obesity and metabolic syndrome. The latter condition in the childhood and adolescence is characterized by the pronounced disturbances of basal metabolism, vasoactive systems, psychoemotional status, and regulatory hormonal functions that determine the choice of rehabilitative modalities. The combined treatment of such disturbances is considered to be an efficacious method for the rehabilitation of these patients. It is recommended that cortexin be prescribed to the children presenting with obesity and metabolic syndrome because this medication promotes correction of the hormonal and metabolic status and improves the brain cognitive function.

[The impact of age and gender on the indicators of coagulator and vascular thrombocyte hemostasis in patients with II type diabetes mellitus].

The conditions of coagulator and vascular thrombocyte hemostasis in patients with II type diabetes mellitus were investigated depending of age and gender. The analysis of indicators demonstrated that in males the conditions of hypercoagulation develops in earlier age in comparison with females. The results testify male greater susceptibility to the development of atherosclerosis. It indicates the necessity to take into account the age criteria and gender differences during anticoagulating treatment.

[A case of hemolytic-uremic syndrome with development of catastrophic antiphospholipid syndrome: diagnosis and clinical tactics].

The paper describes a case of practically simultaneous development of the hemolytic-uremic syndrome (HUS) and the catastrophic antiphospholipid syndrome (CAPS) complicated by mesenteric vessel thrombosis and small bowel necrosis. Multimodality treatment comprising volume plasmapheresis, fresh frozen plasma transfusion, hemodialysis, anticoagulant and disaggregant therapy could relieve thrombogenic events, such as pulmonary artery thromboembolism and intestinal necrosis.

[Acute abdominal syndrome in blood system diseases].

AIM: To define an optimal diagnostic and therapeutic algorithm when the acute abdominal syndrome occurs in hematological patients. MATERIALS AND METHODS: The results of 145 emergency surgeries made in 2006-2008 for acute abdominal syndrome were studied in patients with blood system diseases. RESULTS: Clinical manifestations of acute abdominal syndrome emerge in 1-1.4% of all the patients treated at the Hematology Research Center, Russian Academy of Medical Sciences. There is a need for surgery in 0.5-0.7% of all the patients admitted. In this group of patients, annual postoperative mortality is 12-16%. CONCLUSION: The routine algorithm for a diagnostic search in hematological patients with acute abdominal syndrome can lead to both hyperdiagnosis and unwarranted surgery, and incorrect choice of expectant policy as well.

[Renal monoclonal immunoglobuline deposition disease as a rare variant of renal damage in multiple myeloma].

A case of the immunoglobuline deposit disease diagnosis in MM patient having the symptoms of intensive proteinuria, macrohematuria and terminal renal failure is reported. The disease was diagnosed by the evidence from electron microscopy of the kidney and liver biopsies.

[Use of fractional plasma separation and adsorption (Prometheus technology) in the treatment of acute liver failure].

This paper presents the results of treating 8 patients with acute liver failure, by using the separation and adsorption of fractional plasma (Prometheus technology). Twenty-five procedures lasting 5-6 hours were performed. Anticoagulation with heparin was made under guidance of coagulogram parameters. The results of testing blood parameters before and after a procedure and hemodynamic parameters are given. The investigations have demonstrated the effectiveness and safety of the procedure.

[Hyperhomocysteinemia--one of the factors underlying thrombotic complications in patients with chronic myeloproliferative diseases].

AIM: To assess incidence of hyperhomocysteinemia (HHC) in patients with chronic myeloproliferative diseases (CMPD) and to analyse possible correlation between an elevated concentration of plasma homocystein (HC) and thrombotic complications. MATERIAL AND METHODS: The trial enrolled 61 patients: 39 CMPD patients with thrombotic complications and free of them, 22 nonhematological patients with thrombosis. The control group consisted of 40 healthy donors. The examination protocol included determination with standard methods of HC plasma concentration, platelet and plasma components of hemostasis, mutation of factor V Leiden gene, prothrombin and methylenetetrahydrofolate reductase (MTHFR). RESULTS: Mean HC concentration in the serum in CMPD patients was 19 +/- 1.7 mcmol/l which appeared higher than in healthy donors (12 +/- 1.3 mcmol/l). The highest HC was in patients with subleukemic myelosis (SLM)--23 +/- 2.3 mcmol). No difference in HC concentration in plasma was observed in CMPD carriers of homo- or heteroxygous mutation of C667T gene or CMPD patients without the mutation. In CMPD content of factor VIII was higher in HHC than in normal HC (222 +/- 26.5 and 116 +/- 20%, respectively, p = 0.002). For von Willebrand factor 202 +/- 15.6 and 120 +/- 14.6%, respectively (p < 0.003). HC reduction in response to vitamin therapy was the greater the higher its initial level was. CONCLUSION: There is correlation between HHC and thrombosis in CMPD patients. HC concentration may depend on the proliferative stage of CMPD. As HC is a significant independent factor of thrombotic complications risk, it is necessary to detect and treat HHC.

[The genetic and biochemical mechanisms of the development of diabetic nephropathy in children].

The mechanisms responsible for the development of microangiopathies in type diabetes mellitus (DM1) are complex and under extensive study. Fresh data on the pathogenesis of DM1 make it possible to direct actual ways to the studies aimed at preventing the complications of this disease. The purpose of this study was to examine the contribution of the polymorphic types of the VNTR polymorphism of endothelial NO-synthase gene (NOS3) and the I/D polymorphism of angiotensin-converting enzyme (ACE), the status of the proteolytic systems and lipid metabolic disturbances to the development of diabetic neuropathy (DN). A total of 197 children Работа выполнена при финансовой поддержке гранта РГНФ № 00-06-00- 162а. who had DM1 in 1996-2002 were examined. Their mean age was 13.1 ±0.3 years. A control group comprised 32 apparently healthy children whose mean age was 12.8±0.1 years. DN was present in 44 children (19 boys and 25 girls). It has been established that allele A of endothelial NO-synthase is less common in diabetic patients with nephropathy (p < 0.05) and that it is a factor that reduces, while insignificantly, the risk for nephropathy (RR = 0.13). Analyzing the association with pathology by using the transmission/disequilibrium test has indicated the association of allele В of the gene NOS3 (TDT = 4.5, p - 0.034) and allele D of the gene ACE (TDT = 3.6, p < 0.05) with DN. The activity of plasma kallikrein was increased at the early stages of nephropathy (hyper-function). The higher activity of angiotensin-converting enzyme (57.0±2.9 µmol/min·l in the patients with nephropathy versus 38.1±2.8 µmol/min·/ in those without this disease) and the substantial suppression of α-proteinase inhibitor (21.1+-1.2 IU/ml in nephropathy at the stage of proteinuria versus 27.6±1.6 IU/ml without nephropathy) make a contribution to the development of nephropathy at the stages of microalbuminuria and proteinuria. ffyperlipidemia that manifests itself by the increased levels of cholesterol, triglycerides, and low-density lipoprotein cholesterol and by the decreased levels of high-density lipoprotein cholesterol is one of the mechanisms responsible for the development of DN in DM1.

[Significance of kallikrein, angiotensin-converting enzyme, and proteolysis inhibitors in vascular complications in diabetes mellitus type 1 in children]. / Znachenie kallikreina, angiotenzinprevrashchaiushchego fermenta i ingibitorov proteoliza pri sosudistykh oslozhneniiakh sakarnogo diabeta tipa 1 u detei.

Searching for markers triggering the vascular complications in diabetes mellitus, type 1, is a topical issue of modern endocrinology. The study focuses on the parameters of the kallikrein-kinin, rennin-angiotensin systems and on proteolysis inhibitors involved in hemodynamics regulation. It was established that, at earlier diabetes stages, which are characterized by polyuria, the activity of blood-plasma kallikrein is increasing, while, at the disease later stages and in the process of nephropathy progression, there is an increasing activity of the angiotensin-converting enzyme accompanied by an essential suppression of the alpha 1-proteinase inhibitor.

[Enzymes of purine metabolism of lymphocytes and eosinophiles in bronchial asthma]. / Fermenty purinovogo obmena limfotsitov i éozinofilov pri bronkhial'noi astme.

The activity of the enzyme purine metabolism (5'-nucleotidase, adenosine deaminase, xanthine oxidase and the content of uric acid, i.e. the final product of the purine metabolism) were determined in lymphocytes, eosinophiles and blood serum of patients with bronchial asthma. The activity of 5'-nucleotidase in lymphocytes, eosinophiles and blood serum of patients with bronchial asthma was found to be reduced by 5-7-% as compared with the controls. The activity of adenosine deaminase in lymphocytes, eosinophiles and blood serum was found to be reduced in a majority of patients. An increased activity of adenosine deaminase was higher in lymphocytes and blood serum of 38% of the examined patients. The activity of xanthine oxidase in lymphocytes and eosinophiles of patients exceeded by 2.4 and 1.7 times the control value, respectively. The content of urine acid was found to be increased, in bronchial asthma, by 2.7 times. Consequently, the balance of enzyme reactions of the purine metabolism is impaired in bronchial asthma, and there is an accumulation of urine acid.

Protein interaction with hydrated C60 fullerene in aqueous solutions.

Physicochemical effects of hydrated C(60) fullerenes (HyFn) on serum albumin molecules were studied using ESR spin labeling and differential scanning microcalorimetry. Molecular-colloidal solution of hydrated C(60) fullerenes and their small spherical fractal clusters in water (C(60)FWS), was shown to stabilize protein hydration, and decrease specific surface energy in water-protein matrix in salt solutions. The mechanism of HyFn interaction with protein is discussed in terms of HyFn induced formation of protein clusters and phase transition of hydration water.

[Lipids of lymphocyte plasma membranes in patients with atherosclerosis and their children]. / Lipidy plazmaticheskikh membran limfotsitov u bol'nykh aterosklerozom i ikh detei.

Phospholipid composition and activity of 5'nucleotidase of lymphocyte plasmatic membranes were studied in patients with atherosclerosis (AS) and their children. The content of phosphatidylcholine, cholesterol/total phospholipid ratio, transmembrane asymmetry of lipids were increased, 5'nucleotidase activity decreased, and lymphocyte plasmatic membranes contained accumulations of lisophospholipids (LPL). This indicated increased hydrophobia and decreased functional activity and damage of lymphocyte plasmatic membranes. Increased transmembrane lipid asymmetry and LPL accumulations were detected in the lymphocyte plasmatic membranes of children with aggravated heredity for AS. Presumably these disorders anticipate the changes in the structure of plasmatic membranes, observed in adult patients with AS, and progress in case of exposure to unfavorable factors.

[Indices of proteolysis in evaluation of resorption in bone tumors]. / Pokazateli proteoliza v otsenke rezorbtsii pri opukholiakh kosti.

Activities of acid and alkaline phosphatases, collagenase, cathepsin D, trypsin-like proteinases, alpha(1)-proteinase inhibitor (alpha(1)-PI), alpha(2)-macroglobulin (alpha(2)-MG) were measured in blood plasma and tumor tissue of patients with giant-cell tumor of the bone (GCTB) and bone chondrosarcoma. These tumors differed by enzymatic activities. GCTB is characterized by increased activity of alkaline phosphatase, while in chondrosarcoma tissue the activities of collagenase and cathepsin D were the highest. Activities of acid phosphatase, collagenase, trypsin-like proteinases were increased in the plasma of patients with both tumors; alpha(1)-PI/alpha(2)-MG ratio was increased. Bone resorption parameters correlated with proteolysis inhibitors. Activities of collagenase and acid phosphatase were increased in tumor tissue and plasma in the presence of low activities of alpha(2)-MG and increased alpha(1)-PI/alpha(2)-MG index, which seems to require special attention during the postoperative period.

[The activity of trypsin and proteolytic inhibitors in complicated forms of appendicitis in children]. / Aktivnost' tripsina i ingibitorov proteoliza pri oslozhnennykh formakh appenditsita u detei.

The activity of trypsin, alpha 1-proteinase inhibitor, and alpha 2-macroglobulin (MG) was measured in the blood plasma of patients with destructive appendicitis and localized and generalized peritonitis during admission to hospital and for 3 weeks after surgery. A deficit of MG was found in all forms of these diseases. A decreased activity of MG in the blood plasma is apparently a risk factor for emergency inflammatory diseases of abdominal organs. After appendectomy a more demonstrative index of patient's status is trypsin activity, an increase of which is most of all expressed in generalized peritonitis. Quantitative assessment of the trypsin-inhibitor system activity before and after surgery is necessary for a more accurate diagnosis and for monitoring the quality of treatment.