[The possibility of using integral indicators of thrombodynamics for the safety of rehabilitation treatment after a stroke]. / Vozmozhnost' ispol'zovaniya integral'nykh pokazatelei trombodinamiki dlya bezopasnosti reabilitatsionnogo lecheniya posle insul'ta.

OBJECTIVE: To assess the possibility of using the integral indicators of thrombodynamics to improve the safety of rehabilitation measures in patients in the recovery period of stroke. MATERIAL AND METHODS: A prospective study included 52 patients in the recovery period of stroke. To compare the effect of the intensity of physical activity on the change in the integral indicators of thrombodynamics in accordance with the objectives of the study, the patients were randomized into two groups. In the first group, patients received treatment, including physiotherapy, stabilometric trainings, neuropsychological tasks. Patients of the second group received complex treatment, including more intense physical activity with the use of cyclic exercises, biomechanotherapy. To assess the state of hemostasis, an integral thrombodynamics test was used, and the numerical parameters of the spatial dynamics of the growth of a fibrin clot were calculated. RESULTS: The state of compensated hypercoagulability was revealed in the majority of patients before the start of medical rehabilitation, despite taking antithrombotic therapy, which was evidence of the ineffectiveness of the therapy. At the same time, it was noted that it was its action, probably during the ongoing program of physical rehabilitation, that ensured the stability of the integral indicators of thrombodynamics and the absence of clinically significant unwanted thromboembolic complications. As a result of the analysis of the data in dynamics before and after treatment, a direct relationship was traced between the intensity of physical activity and the tendency to disturb the hemostatic balance. CONCLUSION: The intensity of physical activity during treatment undoubtedly influenced the state of hemostasis. The expediency of monitoring the dynamics of coagulation activity in patients in the recovery period of stroke has been demonstrated.

[Prevention of thrombohemorrhagic postoperative complications in patients with benign prostatic hyperplasia].

AIM: To improve the results of surgical treatment of benign prostatic hyperplasia. MATERIALS AND METHODS: The study investigated the effectiveness of a comprehensive preoperative preparation of patients with benign prostatic hyperplasia. The clinical efficacy of traditional methods of preoperative preparation (compression bandaging of the lower extremities during surgery and in the postoperative period and Fraxiparine at a prophylactic dose) was compared with the same preoperative protocol used in combination with intravenous laser blood irradiation. The explored parameters included changes in clinical and laboratory coagulation indices and prostatic blood flow measured by Doppler sonography. The real time visualization was used to assess the effect of intravenous laser irradiation of blood on the morphofunctional state of platelets. CONCLUSION: The study findings showed a high effectiveness of intravenous laser blood irradiation in preoperative preparation of patients with benign prostatic hyperplasia. It was found to reduce the incidence of thrombotic events by 6% and hemorrhagic complications by 4.9% (p<0.05).

[Some features controlling the blood D-dimer level after resection of malignant brain glioma]. / Nekotorye zakonomernosti, opredeliaiushchie uroven' D-dimera krovi posle rezektsii zlokachestvennoi gliomy golovnogo mozga.

A high blood D-dimer level is often diagnosed in patients with malignant brain glioma (MBG), with 24% of these patients being detected with deep vein thrombosis of the leg and/or pulmonary embolism (PE). The cause of an elevated blood D-dimer level in most other cases remains unclear. The purpose of this study is to identify the features associated with an increased blood D-dimer level in patients after MBG resection, which may be used to improve the efficacy of adjuvant radiation therapy (ART). RESULTS: The study included 50 patients. Three to four weeks after resection of malignant brain glioma (MBG), the blood D-dimer level was determined in patients immediately before the onset of ART. An increase in the blood D-dimer level more than by 0.25 µg/mL was detected in 78% of patients. More often, a high D-dimer level was detected in patients aged 60 years or more. In the same age group, an increase in the D-dimer level was significantly larger (p<0.05) than in younger patients (1.2 and 0.6 µg/mL, respectively). The degree of brain tumor malignancy did not affect the rate and value of an increase in the blood D-dimer level. CONCLUSION: Our findings indicate that an increased blood D-dimer level in patients without symptoms of venous thrombosis after craniotomy for MBG is more pronounced in patients aged 60 years and over. The degree of glioma malignancy has no significant effect on this indicator.

[The effect of cholesterol on the electrokinetic properties of erythrocyte membranes in chronic cerebral ischemia]. / Vliianie kholesterina na élektrokineticheskie svoĭstva membran éritrotsitov pri khronicheskoĭ ishemii golovnogo mozga.

AIM: To determine the effects of total plasma cholesterol on the electrokinetic properties of erythrocyte membranes of healthy volunteers and patients with chronic cerebral ischemia (CCI). MATERIAL AND METHODS: Authors studied the erythrocytes from venous blood of 95 patients with CCI and 54 healthy people (controls). To perform an electrophoretic cell analysis of erythrocytes, we used the shorthand method of computer microelectrophoresis. RESULTS AND CONCLUSION: Plasma cholesterol level increased with the age. In the control group, there were the increase in percentage of fixed red blood cells, decrease in the amplitude of oscillations and electrophoretic mobility of red blood cells. In CCI patients, a significant increase in the share of fixed red blood cells, decrease in the amplitude of oscillations and electrophoretic mobility were observed compared to the controls. An increase in percentage of fixed red blood cells as well as in the qualitative heterogeneity of red blood cells in the amplitude of the oscillations was identified both in patients and controls, regardless of sex and age, with higher levels of total cholesterol.

[ACTIVITY OF ANTIMICROBIAL NANOSTRUCTURED BARRIER LAYERS BASED ON POLYETHYLENETEREPHTHALATE IN RELATION TO CLINICAL STRAINES OF MICROORGANISMS FOR SICK PERSONS OF GASTROENTEROLOGICAL PROFILE].

Homeostasis transgressions of enteral medium including disbiotic ones are often accompanying deseases of digestive tract. Espessially it touches upon sick persons connected with probe nourishing. One of the way for solving this problem is normalization of digestion microflore by means of wares with nanotechnological modifications of walls (probes, stomic tubes) which provide them antimicrobial properties and assist to normalization of digestive microbiotis and enteral homeostasis completely. The aim to study is research of antimicrobial activity of of nanostructured barrier layers based on polyethyleneterephthalate (PET) in relation to clinical straines of microorganisms. For barrier layer creation the approach on the base of methods of ion-plasma technology was used including ion-plasma treatment (nanostructuring) of the surface by ions noble and chemically active gases and following formation nanodimensional carbon films on the surface/ For the study of antimicrobial activity in relation to clinical straines of microorganisms we used the technique which allowed to establish the influence of parting degree of microorganisms suspension and time for samples exposing and microorganisms adsorbed on the surface. In experiment clinical straines obtained from different materials were used: Staphylococcus Hly+ and Calbicans--from pharyngeal mucosa, E. coli--from feces, K.pneumoniae--from urine. Sharing out and species identification of microorganisms were fulfilled according with legasy documents. In results of the study itwas obtained not only the presence of staticticaly confirmed antimicrobial activity of PET samples with nanostructured barrier layers in relation to different stimulators of nosocomical infections but also the influence of different factors connected with formation of nanostructured layers and consequently based with them physicochemical characteristics such as, in particular, surface energy, surface relief parameters, surface charg and others, as well as influence of microorganisms nature onto the interaction of between barrier layers and microorganisms.

[Additional indicators of the assessment of efficacy of disease modifying drugs (preliminary results)].

The working experience of the Moscow oblast center for multiple sclerosis is analyzed. Along with standard methods of treatment efficacy evaluation, a cytokines (tumor necrosis factor alpha, gamma-interferon, interleukins 10 and 17) measurement, a morphological study of CD4 and CD8 lymphocytes with cell microelectrophoresis, a complex of morphometric and optic cell parameters using laser computed phase-interference microscopy and cell optic coherent tomography of the eye's retina are used. Preliminary results of the efficacy of these methods are presented.

[Changes in plasmic and platelet hemostasis in patients with chronic renal failure in hemodialysis].

Plasmic and platelet components of hemostasis were examined in 50 patients with terminal chronic renal failure (CRF) aged 23 to 67 years and 30 healthy controls of the same age. A plasmic hemostasis component was studied basing on 11 parameters of coagulogram. A platelet hemostasis component was studied by platelet aggregation: spontaneous and induced by ADP (in concentration 1.25, 2.5 and 5.0 mkg/ml), collagen, adrenalin and ristomycin. All CRF patients before hemodialysis had a significant alterations of 6 indices of a plasmic component of hemostasis: activated partial thromboplastic time, content of soluble fibrinmonomeric complexes, thrombine time; of 3 from 7 tests of aggregatogram (ADP, collagen, ristomycin induced aggregation). After hemodialysis severity of the above pathological shifts deteriorated (1.5 to 5 times). Thus, CRF patients on hemodialysis showed aggrevation of impairment of all hemostasis components. They are at risk of hypercoagulation, DIC-syndrome, massive thromboembolism. The above impairment of hemostasis should be considered in prescription of anticoagulant therapy to CRF patients. Monitoring of hemodialysis and adequate correction of the hemostasis system defects may contribute to improvement of quality of life of patients with terminal CRF and lowering of their mortality rate.

[Dynamics of morphometric parameters of peripheral blood platelets as a criterion in assessing thrombogenicity of dialysis membranes].

The study enrolled 45 patients with terminal chronic renal failure (CRF) aged 24-57 years on hemodialysis (a study group) and 30 healthy subjects of matched age (a control group). Morphofunctional condition of circulating platelets in situ was assessed by vital computer morphometry using computer phase-interference microscope, the analysis was made of opticogeometric parameters and morphological features of live platelets reflecting the degree of their activation. CRF patients' proportion of different platelet types in circulating population was 56.5, 34, 8.7 and 0.8% (platelets in situ, platelets with low, high activation, degenerative) versus 59.4, 28.1, 10.5 and 2% in the controls, respectively. Changes in morphological composition and opticogeometric parameters of circulating platelets were found in the dialysis membrane after a hemodialysis procedure. The changes were less or more pronounced depending on the dialysis membrane type. Thus, vital morphometric platelet parameters reflect condition of the platelets allowing quantitative assessment of impairment of the structure and functional activity of the cells in CRF progression. Hemodialysis procedure results in characteristic alterations of morphofunctional status of circulating platelets related, to a certain degree, to the material of extracorporeal outline. This dictates necessity of objective evaluation of such impact and prognosis of thrombogenic complications. Morphometric parameters of platelets can serve objective criteria of dialysis membrane thromboginicity.

[Investigation of lymphocytes activation using a method of coherent phase microscopy].

Investigation of initial stages of T-lymphocytes activation was performed by coherent phase microscopy (CPM) based on the measurements of phase thickness and diameter of the cell and its organelles. Lymphocytes where activated in two ways: by addition of 2 10-6 g/ml phytohemagglutinin (PHA) and with He-Ne laser (lambda = 633 nm, 10-3 W) radiation. It was shown that phase thickness is proportional to refractivity (difference between refractive indices of an object and the surrounding medium) and geometrical thickness. Phase thickness decreased during activation independently of the nature of the stimuli. Phase thickness in healthy donors was 220 + 60 nm; decreased to 110 + 30 nm 1 h after addition of PHA. The same values were achieved 30 min after stimulation with the He-Ne laser. Characteristic changes in phase thickness in the nucleus and nucleolus were observed after lymphocytes were stimulated with the laser.

[Computer morphometry of lymphocytes in the diagnosis of chronic transplant nephropathy].

AIM: to assess the role of immunological mechanisms in the development and progression of chronic transplant nephropathy (CTN) and the prognostic value of rapid computer morphometry of lymphocytes in predicting the risk of renal allograft rejection. SUBJECTS AND METHODS: Thirty-seven renal graft recipients (29 males and 8 females; mean age 35.9 +/- 2.2 years; mean time after renal allografting 19.9 +/- 2.7 months). Twenty-three patients had satisfactory renal graft function; 14 patients were diagnosed as having CTN. A control group included 30 apparently healthy individuals. Along with physical examination, vital computer phase morphometry (CPM) of peripheral blood immunocompetent cells was carried out in all the patients. RESULTS: Small and average cells were predominant in the T and B lymphocyte populations. In CTN, there were increases in diameter, perimeter, and area and decreases in the phase height and volume of B lymphocytes, which is indicative of their activation. There was a predominance of average B lymphocytes in CTN. CONCLUSION: Vital CPM of peripheral blood immunocompetent cells may be used for the early diagnosis and prediction of CTN development.

[Morphofunctional characteristics of neutrophils in patients with autoimmune thyroiditis].

AIM: To study morphofunctional status of neutrophilic polymorphonuclear leukocytes (NPNL) in patients with chronic autoimmune thyroiditis (CAIT). MATERIAL AND METHODS: The morphofunctional status of NPNL was investigated with vital computer phasic morphometry (CPM) in 25 patients (24 females and 1 male, mean age 45.4 +/- 3.2 years) with verified CAIT and 20 healthy females. Solid phase enzyme immunoassay examined the serum for IL-8 content. RESULTS: CAIT patients have characteristic features of neutrophil morphofunctional state (changed cell size, disproportion in population morphological structure), IL-8 level was 13.9 fold higher than normal--63.8 pg/ml. CONCLUSION: CAIT patients demonstrate activation of the mechanisms which regulate cell nonspecific resistence. As a result, locomotor, secretory and phagocytic NPNL functions enhance. Changes detected may reflect severity of the pathological process and indicate growing autoaggression in CAIT patients.

[Modern approach to pathogenetic therapy of the oral mucosa lichen].

Study of humoral immunity, morphofunctional status of cell factors of immunologic reactivity (T-lymphocytes, neutrophils) and intestinal microecology allowed design of comprehensive pathogenetic therapy of oral lichen.

[Acyclic nucleoside analogues. III. Synthesis of new 2',3'-dideoxy-2',3'-didehydronucleoside analogues]. / Atsiklicheskie analogi nukleozidov III. Sintez novykh atsiklicheskikh analogov 2'3'-didezoksi-2',3'-didegidronukleozidov.

The coupling of 5-acetoxy-1,1-dimethoxypent-2-ene with cytosine and thymine trimethylsilyl derivatives, as well as the reaction of 5-acetoxy-1-bromopent-2-ene with adenine sodium salt, yielded acyclic analogues of the corresponding nucleosides containing 5'-acetoxy groups. They were deprotected with a saturated methanolic solution of ammonia to the target analogues of nucleosides, which were characterized with 1H NMR, IR, and UV spectra. The English version of the paper: Russian Journal of Bioorganic Chemistry, 2004, vol. 30, no. 6; see also http://www.maik.ru.

Correlation between the results of glucocorticoid therapy and in vitro effect of glucocorticoids on monocytes in asthma.

The effects of glucocorticoids on monocyte morphology and function in vitro and the results of high-dose budesonide therapy in patients with non-severe bronchial asthma were analyzed. Before therapy with inhalation glucocorticosteroid (budesonide) characteristics of blood monocytes and the effects of different concentrations of prednisolone on these cells were studied in vitro by luminol-dependent chemiluminescence and computer-assisted phase-interference microscopy. High sensitivity of patients to budesonide was associated with pronounced in vitro inhibitory effect of prednisolone on monocyte activity, which was not observed in cases with delayed effects of therapy. Pronounced inhibitory effects of glucocorticoids on monocytes in vitro were observed in patients both resistant and highly sensitive to glucocorticoid therapy. Hence, the resistance of patients with non-severe asthma to high-dose budesonide therapy is not related to the weakening of the inhibitory effect of glucocorticoids on monocyte activity.

[Prognostic criteria of efficacy of inhalation glucocorticosteroids in non-severe bronchial asthma]. / Prognosticheskie kriterii éffektivnosti ingaliatsionnykh gliukokortikosteroidov pri netiazheloi bronkhial'noi astme.

The aim of the study was to evaluate efficacy of inhalation glucocorticosteroid (GCS) drugs in patients with persisting bronchial asthma (BA) previously steroid untreated and identify factors influencing the results of GCS therapy. 67 patients with non-severe BA given long-term theophilline with inadequate effect received inhalation GCS drug budesonid which produced a complete clinical effect (group 1), a delayed effect (group 2) or no effect (group 3). The above groups were compared by clinico-anamnestic data, functional respiration parameters, chemiluminescence of mononuclear cells of the peripheral blood measured before therapy with budesonide. The discriminant analysis estimated the minimal set of the initial parameters by which the groups differ. The regression model was used to calculate an individual prognostic index of probable treatment efficacy for each patient. The results of the study agree with the view on BA as a multistage disease in which chronic persisting inflammation provokes progressive remodeling of the respiratory tracts and formation of pathophysiological disorders resistant to glucocorticoids. It is necessary to use inhalation GCS drugs early in persistent BA. They are strictly indicated if BA patients need regular daily intake of short-term beta 2-agonists.

Effects of liposomes of different phospholipid composition on the induction of respiratory burst in human blood monocytes and alveolar macrophages.

Liposomes made from phosphatidylcholine (PC) or PC-fatty acid ester mixtures have been shown to induce an activation of the respiratory burst in human blood monocytes and alveolar macrophages (AM). Incorporation of 1,2-diacylglycerol or arachidonic acid into PC liposomes significantly enhanced the effect. In the case of AM, the effect of PC liposomes was similar to those of phorbol 12-myristate 13-acetate (PMA) and the ionophore A 23187, while in monocytes, PMA and A 23187 induced a stronger respiratory burst than PC liposomes. In the presence of PMA, higher liposomal concentrations were required to produce the maximum activation of the respiratory burst in both types of cells.

[Characteristics of phospholipid hydrolysis kinetics by phospholipase C from Bacillus cereus. Hydrolysis of phosphatidylinositol in various aggregated states]. / Osobennosti kinetiki gidroliza fosfolipidov fosfolipazoi C iz Bacilluscereus. Gidroliz fosfatidilétanolamina v razlichnykh agregatnykh sostoianiiakh.

The process of phospholipase C hydrolysis of phosphatidylethanolamine (PE) in the form of mixed micelles phospholipid-detergent or in the form of vesicules in the mixture with phosphatidylcholine (PC) was studied. The size of the micelles was measured by dynamic light-scattering and their structure was determined by 31P-NMR spectroscopy. It was found that the kinetics of PE hydrolysis in the micelles by phospholipase C from Bacillus cereus do not follow Michaelis-Menten equation, but at all concentrations studied PE was hydrolyzed significantly slower than PC. The rate of PC hydrolysis was measured in the previous work. The hydrolysis of PE in PC-vesicules was followed with use of Victoria blue R dye method. It was shown that the rate of PE hydrolysis in the vesicules is similar to that of PC.