[Treatment of necrotizing infection in patients with chronic arterial insufficiency of the lower extremities]. / Rezul'taty lecheniia nekrotiziruiushchei infektsii u patsientov s khronicheskoi arterial'noi nedostatochnost'iu nizhnikh konechnostei.

OBJECTIVE: To analyze the effectiveness of complex therapy of necrotizing infection using the original method of stimulation of angiogenesis in patients with chronic arterial insufficiency of the lower extremities. MATERIAL AND METHODS: In 53 patients, operations were performed using the proposed technologies for stimulation of angiogenesis. A control group consisting of 56 patients was formed to compare the results of treatment. They had standard vascular therapy for the correction of ischemia. Morphological studies of the muscles of the lower extremities included assessment of capillary bed density and spatial orientation of the capillaries before and after treatment. Computed angiography of the lower extremities followed by calculation of perfusion index was performed to assess changes in the microvasculature. Clinical evaluation of the results was carried out using R. Rutherford scale. RESULTS: Revascularization resulted significant augmentation of capillary bed density and the number of functioning capillaries in muscular tissue. This was accompanied by increased perfusion index and TcPO2 values. The effect of treatment is observed in 12-14 days after surgery and persists for a long time. The best outcomes are found in patients with ischemia grade IIb-III. Incidence of lower limb amputations was more than 2 times lower in the main group compared with the control group. CONCLUSION: Combined stimulation of angiogenesis including mechanical tunneling of the muscles of the affected limb and administration of platelet rich plasma is effective procedure. This method does not require complex equipment and may be used in the treatment of patients with complications of chronic lower limb ischemia and contraindicated direct arterial reconstruction.

Standing wave approach in the theory of X-ray magnetic reflectivity.

An extension of the exact X-ray resonant magnetic reflectivity theory has been developed, taking into account the small value of the magnetic terms in the X-ray susceptibility tensor. It is shown that squared standing waves (fourth power of the total electric field) determine the output of the magnetic addition to the total reflectivity from a magnetic multilayer. The obtained generalized kinematical approach essentially speeds up the calculation of the asymmetry ratio in the magnetic reflectivity. The developed approach easily explains the peculiarities of the angular dependence of the reflectivity with the rotated polarization (such as the peak at the critical angle of the total external reflection). The revealed dependence of the magnetic part of the total reflectivity on the squared standing waves means that the selection of the reflectivity with the rotated polarization ensures higher sensitivity to the depth profiles of magnetization than the secondary radiation at the specular reflection condition.

Interference phenomena of synchrotron radiation in TEY spectra for silicon-on-insulator structure.

The general matrix theory of the photoelectron/fluorescence excitation in anisotropic multilayer films at the total reflection condition of X-rays has been developed. In a particular case the theory has been applied to explain the oscillation structure of L(2,3) XANES spectra for a SiO(2)/Si/SiO(2)/c-Si sample in the pre-edge region which has been observed by a sample current technique at glancing angles of synchrotron radiation. Remarkably the phase of the oscillations is reversed by a ∼2° angle variation. The observed spectral features are found to be a consequence of waveguide mode creation in the middle layer of strained Si, which changes the radiation field amplitude in the top SiO(2) layer. The fit of the data required the correction of the optical constants for Si and SiO(2) near the Si L(2,3)-edges.

[Sarcomatoid carcinoma of the thymus].

Sarcomatoid carcinomas are rare malignancies composed of epithelial (carcinomatous) and sarcomatous elements. High-grade carcinoma is difficult to diagnose by light optic and immunohistochemical studies. The authors give the data available in the literature on sarcomatoid carcinoma of the thymus and also describe their own observation. Its histological pattern is represented by a combination of carcinomatous and sarcomatous elements with extensive necrotic foci. Immunohistologically, the tumor cells expressed total cytokeratin (AE1/AE3), CD99, and focally epithelial membrane antigen. Some tumor cells were vimentin- and SMA-positive. Markers, such as chromogranin A, bcl-2, bcl-6, S-100 protein and myogenin, were negative.

[Pathogenetic therapy of tuberculosis of respiratory organs during sanatorium-and-spa treatment].

The objective of this study was to evaluate the efficiency of combined inhalation of cycloferon for 5 weeks and oral intake of cytoflavin during the period of sanatorium-and-spa treatment of the patients with pulmonary tuberculosis. It was shown that combined immunotrophic and antioxidative treatment promotes resolution of focal and infiltrative lesions in the lungs, normalization of hemograms, and minimization of the activity of cytolytic and cholestatic markers of the liver.

[The psychoemotional status of adolescent girls living in the urbanized areas and its association with their reproductive health].

The detected characteristics of the psychoemotional status of teenage girls living in the urbanized areas, particularly under socioeconomical ill-being can hamper their social adaptation, deform the type of gender behavior, and be a risk factor of their reproductive behavior. In this connection, there is a need for activating the interaction of medics and psychologists in the structure of a medicopedagogical stage of prophylactic medical examinations and for introducing stress-limiting exposures into the educational establishments.

[Comparative diagnostic characteristics of carbohydrate metabolism disorders in women with polycystic ovary syndrome (PCOS)]. / Sravniavane na diagnostichnite pokazateli za otsenka na narusheniiata vuv vuglekhidratniia metabolizum pri zheni sus sindrom na polikistozni iaichnitsi (PCOS)

The aim of the study was to compare the information provided by both fasting and stimulated during a standard oral glucose tolerance test (oGTT) levels of glucose and insulin as regards glucose tolerance and insulin resistance in women with PCOS. Few criteria are used in practice to verify insulin resistance in PCOS--elevated fasting insulin, decreased basal glucose/insulin ratio (< 6 for glucose in mg/dl or < 0.333 for glucose in mmol/l), insulin increase of more than 100 lul during an oGTT, and HOMA index > 2. The study comprised of 94 women (mean age 21.8 +/- 5 = 8 ys, mean BMI-30.38 +/- 7 = 7 kg/m2), divided in 4 groups according to BMI--group with BMI < 25, n = 21; group with BMI25-30, n = 27; group with BMI = 30-35, n = 23 and group with BMI > 35, n = 23. An oGTT with parallel determination of blood glucose and insulin was performed in all patients. The ratio basal glucose/insulin and HOMA index were calculated. Glucose levels on the 2 md hour during the oGTT pointed at IGT (impaired glucose tolerance) and/or diabetes in 8.5% of the investigated patients while the fasting levels indicated disturbances in only 2.2% of them. Fasting insulin levels were in the normal range in a considerable part of PCOSE women, mainly those with normal weight, and were not predictive for the response of insulin to glucose load. Relative percent of patients with elevated fasting insulin rose with the increasing of BMI. Decreased glucose/insulin ratio, elevated HOMA index, and abnormal stimulation of insulin were seen in more than 2/3 of the PCOS women including nonobese ones. Information provided by the above three markers was similar and they could be used alternatively according to the particular case and assessment of the cost/benefit ratio.

[Psycho-emotional profile of personality among teenage girls living in the Volgograd industrial region]. / Prikhoémotsional'nyi profil' lichnosti devushek-podrostkov, zhitel'nits Volgogradskogo promyshlennogo regiona.

Social, economic and other factors appeared to form psychoemotional personal profile of teenager girls living in significant industrial region subjected to pollution with chemicals varying in jeopardy. The studies proved that ecologic factors may play an important role in formation of psychoemotional personal profile. All this could be a pathogenetic basis for endocrine disorders among teenagers and subsequent reproductive disturbances and birth of diseased children.

[Prognostication of reproductive disorders in women living under different ecologic conditions]. / Prognozirovanie narushenii reproduktivnogo zdorov'ia zhenshchin, prozhivaiushchikh v razlichnykh ékologicheskikh usloviiakh.

Sensitivity of females to environmental hazards is known to increase extremely during pregnancy. The harmful effects could appear not only in mother, but also in fetus. Thus, special importance is associated with materials about effects of environmental hazards in industrial agglomeration on female reproductivity. The authors demonstrate relationships of incidence and severity of female reproductive disorders, neonatal health with actual jeopardy of ecological hazards characteristic for industrial agglomeration of Volgograd region. The data obtained help to consider reproductive and neonatal health parameters which are highly prone to anthropogenous factors and to use those parameters for forecasting the pathologic conditions dependent on ecologic matters. The results could serve as a base for prognosis on demographic situation in Volgograd region by the beginning of XXI century.

A simple and reliable reverse-phase high-performance liquid chromatographic procedure for determination of paclitaxel (taxol) in human serum.

A simple, fast, and reliable isocratic (mobile phase: acetonitrile/methanol/water [48/11/41], reverse-phase (C18 column) high-performance liquid chromatography method for the determination of paclitaxel concentration in human serum is presented. The procedure uses a new and convenient one-step sample-purification procedure that requires only 400 microliters of sample and uses N-heptylbenzamide as an internal standard. Paclitaxel is detected by UV absorbance measurement at 227 nm. The method has a broad linear range (0.01 to 10 mg/l, or 0.012 to 11.7 mumol/l; r > 0.999), and the detection limit is 0.01 mg/l (0.012 mumol/l). The deviation from target value is < or = 1.5%, and coefficients of variation are < or = 13.8% within runs and < or = 15.3% between runs. Recovery paclitaxel is > or = 92.6%. No interferences were observed from endogenous compounds or from more than 30 drugs that may be administered with paclitaxel. Docetaxel, which is not concurrently administered, coeluted with paclitaxel. Compared with previously published high-performance liquid chromatography procedures for the determination of paclitaxel, the particular advantage of the method presented here is its simple and rapid single-step sample-purification procedure, which makes a high recovery of paclitaxel from serum samples possible and results in a pure extract, avoiding interferences from endogenous compounds. The method is suitable for pharmacological studies and routine analysis.

Ectopic ACTH-syndrome due to ovarian carcinoma.

The case of a 60-year-old female with severe and rapidly progressing Cushing's syndrome with fatal consequences is described. Both the clinical and the biochemical findings were consistent with ectopic ACTH production. A computed tomographic (CT) scan revealed intact pituitary and enlarged adrenal glands. Liver metastases were seen but the primary neoplasm was not found. Treatment with aminoglutethimide and other therapeutic measures were unsuccessful. A carcinoma of the right ovary was discovered on autopsy. The tumour cells showed immunoreactivity for neuron-specific enolase (NSE), ACTH and beta-endorphin with differing degree of intensity.

Isoforms of Serratia marcescens nuclease. The role of Mg2+ in the hydrolysis mechanism.

Structural and functional differences between isoforms Sm1 and Sm2, a lack of influence of free Mg2+ on the isoform structures, formation of DNA-magnesium complex serving with great probability as a real substrate for the nuclease has been summarized on the basis of experimental data. Mg2+ forming a complex with phosphate groups of DNA are supposed to further increase the electrophilicity of the phosphorus atoms besides causing a conformational change of the substrate.

Aldosterone response to metoclopramide in patients with prolactinoma: effect of short-term bromocriptine treatment.

The acute effect of 10 mg metoclopramide i.v. on prolactin and aldosterone levels was studied in 8 women with prolactinoma and 8 normal women. The prolactin response to metoclopramide was blunted in hyperprolactinemic patients in comparison with controls. Metoclopramide induced similar aldosterone increases in patients and controls, but hyperprolactinemic women showed a more sustained aldosterone response. Bromocriptine treatment (10 mg daily p.o. for 5 days) in patients with prolactinoma completely suppressed the prolactin response to metoclopramide and the aldosterone response curve was very similar to that of controls. The results did not exclude some degree of suppression of aldosterone in response to bromocriptine.

Effects of corticotropin-releasing hormone on ACTH, cortisol and 13, 14-dihydro-15-keto prostaglandin E2 in patients with diabetes insipidus before and after captopril treatment.

A corticotropin-releasing hormone (CRH) test was performed on 7 patients with central diabetes insipidus (DI) and on 7 healthy subjects. The test was repeated on the patients with DI after 3 days of oral treatment with captopril at a dose of 100 mg daily. No significant difference in the responses of plasma ACTH and cortisol to CRH between the patients and the controls was found. The short-term captopril treatment resulted in a significant decrease of both basal and CRH-stimulated ACTH and cortisol levels in the patients with DI. CRH did not induce any changes in the stable metabolite of prostaglandin E2 13, 14-dihydro-15-keto-prostaglandin E2 (PGE2-M) in the patients with DI before or after the captopril treatment. The results obtained suggest that vasopressin is not an obligatory factor for a normal ACTH response to CRH. Angiotensin II (A II) is involved in the regulation of ACTH. This study confirmed our previous data showing the lack of any specific effect of CRH on PGE2 production.

[Some aspects in financing public health institutions under the conditions of the obligatory medical insurance]. / Nekotorye aspekty finansirovaniya uchrezhdeniy zdravookhraneniya v usloviykh obyazatel'nogo meditsinskogo strakhovaniya.

Analyzes the data of sociologic study carried out among head physicians of therapeutic and prophylactic institutions of the Novosibirsk region, who were asked to express their opinions on the principal problems of public health and its reformation. Although the majority of respondents consider the reforms necessary, almost half of them are sure that the direction of reforms is wrong.