[PROGNOSTIC VALUE OF SOME HEMOSTASIS-RELATED, HOMOCYSTEINE, HIGH SENSITIVE C R P AND MULTIDETECTOR COMPUTED TOMOGRAPHY PARAMETERS IN PULMONARY EMBOLISM].

Nowadays, an arsenal of diagnostic methods is used in diagnosis of pulmonary embolism, which includes x-ray, angiography, perfusion-ventilation scintigraphy, CT and magnetic resonance imaging, Doppler and laboratory studies. Purpose of our study was to evaluate the diagnostic significance of determination of some parameters of hemostasis (D-dimer, Soluble fibrinmonomer complexes, fibrinogen), homocysteine, hs-CRP and multidetector computed tomography in suspected pulmonary embolism. We have examined 54 patients -31 men and 23 women, aged 18 to 76 years, with characteristics of pulmonary embolism. According to our data, Multidetector computed tomography angiopulmonography , measuring D-dimer, fibrinogen and related hyperhomocysteinemia with increased level of hs-CRP may serve as binding, diagnostically significant laboratory markers in the diagnosis and treatment efficacy of pulmonary thromboembolism.

[Development and optimization of diagnostically informative boichemical and coagulative correlators in various atherosclerotic lesions of carotid arteries].

Diagnostically informative biochemical and coagulative correlators in various atherosclerotic lesions of carotid arteries are developed. It has been established positive correlation of the degree of stenosis and intima-media thickness of carotid arteries with the following biochemical parameters: total cholesterol, LDL cholesterol, Apo-B, Lp(a), triglycerides, hs-C-reactive protein(CRP), interleukines (IL-1ß and IL-6), fibrinogen, D-dimers. Negative correlation was stated with respect to HDL cholesterol, Apo-A-1, protein C. The established correlators of carotid intima-medial layer and the studied laboratory indices favour their inclusion into carotid atherosclerosis monitoring.

[Pecularities of atherosclerosis developed after chlamidial infection and behaviour of some hematological and biochemical parameters].

The aim of our studies was to create diagnostically informative criteria of hematologic and biochemical analyses and their combinations as well as to establish relation between Chlamidia Pneumoniae A and atherosclerosis. This is to be done for the purpose of establishing the entire pathogenesis carotid and coronary atherosclerosis and inflammation. The investigation of Chlamidia Pneumoniae infection in proved to be a possible risk factor for the carotid atherosclerosis developed in adults that makes the course of atherosclerosis heavier. As a result of the atherosclerotic process, changes in the blood laboratory parameters were expressed more cases of pneumonia in the children.

[Correlation of some biochemical and coagulological parameters in carotid atherosclerosis].

It has been established positive correlation of the degree of stenosis and intima-media thickness of carotid arteries with the following biochemical parameters: total cholesterol, LDL cholesterol, Apo-B, Lp(a), triglycerides, hs-C-reactive protein(CRP), interleukines (IL-1beta and IL-6), fibrinogen, D-dimers. Negative correlation was stated with respect to HDL cholesterol, Apo-A-1, protein C. Relation between the parameters of the blood lipid spectre, proteins and mediators of inflammation as well as those of hemostasis enables us to approach pathophysiological mechanisms of carotid atherosclerosis, define the processes of inflammation and atherosclerosis.

[The effect of chemotherapy treatment on hemostasis of patients with lung cancer].

Chemotherapy is known to raise the risk of developing thrombotic complications. The aim of our work is to study the system of hemostasis in patients with the lung cancer under chemotherapy treatment. 61 patients were examined (40 men, 21 women) between the ages of 32 and 75 years (the principal group). Chemotherapy was prescribed to 52 patients with the lung cancer considered as non-operable ones, and to 9 patients who refused surgical treatment. Chemotherapy applied to the patients was done by the conventional scheme. The treatment has been conducted from 16 to 20 days.Thrombocytic-vascular hemostasis, plasmatic hemostasis, physiological anticoagulant activity, the blood fibrinolytic activity, markers of intravascular coagulation of the blood and those of fibrinolysis, were studied. The depletion of compensatory mechanisms at all segments of hemostasis in non-operable patients was revealed. The type of reaction points at an oppressive effect of chemodrugs on the hemostasis system and the increase of the risk of development thrombotic complications in those patients.

[Modern view on biochemistry of atherosclerosis].

The article summarizes the literature data on clinical chemistry of pathogenesis of atherosclerosis. According to the up-to-date view, atherogenic are considered the products of chemical modification of LDL, rather than LDL themselves. The modification is created by means of the free radicals or reactive oxidised nitrogen species (RONS). Their rapid and uncontrollable generation in the body may become a prerequisite for the development of a number of diseases and pathological processes, such as atherosclerosis, neurological, malignancies, aging and inflammation and etc... The article describes the chemical nature of free radicals, the mechanism of their action and chain character of their generation. The particular attention is paid to nitric oxide, which is recognized in a broad array of biologic systems, namely, actions on vascular endothelium and mediating macrophage activity. The mechanisms of cell protection from the toxic action of RONS have been elucidated. Based on the experimental data presented, extremely large doses of antioxidants may lead to health problems, rather than confer benefits, because RONS are involved in the mechanisms which increase the survival of cells at unfavourable conditions. The complete impairment of their generation promotes the weakening of cell immunity. The article describes the means to provide cellular cholesterol homeostasis and the uptake of chemically modified LDL by macrophage scavenger receptors. Macrophages consume excess modified lipoprotein becoming foam cells. Foam cells accumulate, releasing growth factors and cytokines that stimulate the migration of smooth muscle cells from the media to the intima, where they proliferate, produce collagen and take up lipid, potentially becoming foam cells which are the main culprits of atherosclerotic changes in the artery walls.

[Diagnostic value of definition of lactate dehydrogenase in mixed saliva in children with periodontitis at diabetes mellitus, type I].

The problem of treatment of periodontitis remains one of the hot topics in practical stomatology. It has been established that modern adaptogenic infection is rather aggressive to whole organism of a human being. All these demands accurate approach while choosing of a conservative method of treatment for such forms as acute and chronic periodontitis. There were 27 children under observation with diabetes mellitus of type 1 (I group). Mean age was 10.5+/-0.75 years. 15 were girls and 13 boys. All patients from the I group were examined for the pathologies of oral cavity. In 100% dryness in a mouth and in 67% bleeding from the gum had been revealed. The mild form of chronic catarrhal gingivitis was revealed in 12 patients, moderate in 5, chronic hypertrophic gingivitis in 8 respectively. Studying of pH of saliva and lactate dehydrogenase (LDH) activity in children with periodontitis developed on the background of recently diagnosed type 1 diabetes mellitus has shown, that pH of saliva was equal to 5.3+/-0.18. In control group (healthy children) pH of saliva was 6.8+/-0.06. In the conclusion it should be emphasized, that we have tried to explain some aspects of multiple character of development of periodontitis at recently discovered insulin-depended diabetes mellitus. Character of changes of some properties of saliva pH and of enzyme activity of LDG promotes to carrying out medical and preventive actions, influencing the main blocks of pathogenesis of this pathological process. Besides, we consider possibility of inclusion the studied parameters of mixed saliva in the algorithm of investigation of periodontitis in children with recently diagnosed type 1 diabetes mellitus.

[The status of carotid arteries and the main vascular risk factors in cerebral infarctions of "anterior circulation"]. / Sostoianie sonnykh arterii i osnovnye sosudistye risk faktory pri infarktakh mozga "perednei tsirkuliatsii".

The aim of the work was to examine the degree of carotid stenosis, the structure of atherosclerotic plaques, and the predominance of the main vascular risk factors in patients with multiple lacunar and comparatively large "non-lacunar" cerebral infarctions. A study WAS made of the data on 110 patients (mean age 62.5 years) with multiple cerebral infarctions revealed by MRT and with stenoses of the internal carotid artery (ICA) of varying degrees of severity. Minor lacunar infarctions (LI) were present in 62 cases whereas comparatively large "non-lacunar" infarctions (NLI) in 48 cases. All the patients underwent standard neurologic examination, laboratory analyses, MRT of the brain with angiography (MRA) of the extra-intrecrania1 vessels, transcranial Doppler (TCD), and examination of the heart for revealing the cardioembolic nature of cerebral infarctions. Among patients with both LI and NLI, arterial hypertension was the most frequently occurring risk factor in 53 (85%) and 35 (73%) patients respectively. In the study groups, there were no appreciable differences in the incidence of high hematocrit, hyperfibrinogenemia, tobacco-smoking, and diabetes mellitus. Patients with NLI demonstrated hypercholesterolemia, CAD and atherosclerosis of the peripheral vessels significantly more often (p<0.05). In the patient group with NLI, hemodynamically significant stenoses of the ICA were predominant: in 18 (37.5%) patients, they were moderate, in 12 (25%) critical, and 7 (14.6%) patients had occlusions whereas in LI, the portion of critical stenoses and ICA occlusions was cooperatively low - in 11 (17.7%) and in 5 (8.1%) patients respectively. Both groups showed the thickening of the complex of the medial CCA layer. Ultrasonopraphy of the vessels has revealed that in patients with NLI and LI, there predominated potentially embologenic plaques, namely in 69% and in 53% of cases, respectively. Our investigations allow to assume that arterial hypertension is the most frequently occurring risk factor of cerebral infarction (both minor lacunar and large "non-lacunar"). Factors such as CAD, hypercholesterolemia, DM, hemorheological disorders, end tobacco-smoking are likely to have an unfavorable impact on both general and cerebral hemodynamics as well as on the microcirculatory bed whereby being on the whole important risk factors of cerebral infarction. Hemodynamically significant stenoses, especially critical ones, occlusions, and embologenic plaques of the ICA are pathogenetically closely linked with the development of "non-lacunar" cerebral infarctions. At the same time they, under certain conditions, may become the cause of multiple lacunar cerebral infarctions.

[Effect of atherogenic risk factors on the state of complex intima-media of common carotid artery]. / Vliianie riada aterogennykh faktorov riska na sostoianie kompleksa intima-mediia obshchei sonnoi arterii.

AIM: To elucidate relationship between presence of atherogenic risk factors (dyslipidemia, hypertension, smoking, etc.) and common carotid artery intima-media thickness. MATERIAL AND METHODS: Color duplex carotid artery scanning and determination of blood lipids, lipo- and apolipoproteins were carried out in 160 patients aged 34-73 (mean 57.4+/-8.2) years. RESULTS: Dyslipidemia, hypertension (diastolic blood pressure > or = 95 mm Hg), smoking and intima-media thickness > 1 mm were present in 57, 49, 54 and 65% of patients, respectively. Intima-media thickness increased with age and in the presence of hypercholesterolemia, hypertension and smoking. Significant (p<0.05) correlations existed between intima-media thickness and levels of total cholesterol (r=0.512), triglycerides (r=0.411), apolipoprotein B (r=0.497), high density lipoprotein cholesterol (r=-0.404), apolipoprotein-A1 (r=-0.386), duration of hypertension (r=0.488). CONCLUSION: Ultrasound study of intima-media thickness allowed to assess harmful effect of various atherogenic risk factors (mechanical - hypertension, biochemical - dyslipidemia, toxic - smoking) on the state of arterial wall.