[A case of thoracic actinomycosis].

A case of thoracic actinomycosis manifest as round shadow in the lung is described. Diagnosis was based on the presence of actinomycetes in a transthoracic lung biopsy sample. Treatment for 3 months resulted in recovery. No relapse was documented during 1 year follow-up period.

[The influence of correction of iron metabolism and erythron characteristics in mild iron deficiency states on clinical manifestations of coronary heart disease].

We studied the influence of correction of iron metabolism and erythron characteristics to normal values in latent iron-deficiency states and mild iron deficiency anemia (IDA) with a hemoglobin level of 130-110 g/l on clinical manifestations of the concomitant coronary heart disease (CHD). The patients were 71 men aged 51.5 +/- 1.1 yr; the control group was comprised 18 age-matched healthy men. CHD and anemia were diagnosed as recommended by RSSC and WHO respectively. Clinical manifestations of both pathologies were compared before and after correction of iron metabolism and erythron characteristics using Sorbifer Durules (Egis, Hungary) in combination with pharmacotherapy ofcardiovascular disorders. Characteristics of iron metabolism and erythron were determined using a Stet Fax 3300 analizer and Vital reagent kits. Sorbifer (200 mg Fe) was given daily for 3 weeks with relevant dietary recommendations. All patients with latent iron-deficiency showed normalization of iron metabolism and those with IDA of both iron metabolism and erythron. In CHD patients, these effects were accompanied by a decrease in the frequency, duration, and intensity of angina, reduced requirement of nitroglycerin, increased tolerance of physical exercises. Also, the severity of co-morbid clinical manifestations (oedema, dyspnoea, palpitation) and heart rate decreased.

[The parameters of collagen proteolytic and metabolic systems in chronic liver diseases of viral and toxic etiologies].

AIM: To study a relationship of the plasma activity of elastase-like and collagenase-like proteinases and their inhibitors to hepatic collagen metabolism and to detect the serum markers of fibrosis severity. SUBJECTS AND METHODS: Three hundred and fifty-nine patients with chronic liver diseases (CLD), including 118 patients with chronic viral hepatitis (CVH), 113 with CVH concurrent with alcoholic liver disease (ALD), 109 with ALD, and 19 with CLD in the presence of opiomania were examined. The activities of alpha1-proteinase inhibitor and alpha2-macroglobulin (alpha2-MG) were determined by the unified spectrophometric assay from the inhibition of N-benzoyl-arginine ethyl ester hydrolysis. The activity of elastase-like proteinases was determined by enzymatic assay from the hydrolysis of the synthetic substrate N-butyloxycarbonyl-L-alanine-para-nitrophenyl ester. That of collagenase-like proteinases was determined, by using a collagen type 1 substrate and expressed in terms of micromoles of the resultant hydroxyproline. The content of hydroxyproline was determined by a color reaction with demethylbenzaldehyde, a free, peptide- and protein-bound hydroxyproline; their fraction was obtained under various conditions of plasma protein isolation and hydrolysis. Plasma fibronectin levels were measured by solid-phase immunoassay. Liver biopsy specimens were morphologically studied in the majority of patients to determine the histological hepatitis activity index and the stage of fibrosis. RESULTS: Fibrois formation in the liver in its chronic diseases was attended by a significant reduction in the activity of collagenase-like proteinases hydrolyzing collagen and by the lower activity of alpha2-MG, an inhibitor limiting collagen formation. CONCLUSION: The identified changes make themselves evident just in early fibrosis, which suggests the rapid onset of imbalance in the mechanisms responsible for regulation of connective tissue synthesis and promotes intensified fibrosis formation.

[Genetics factors determining predisposition to chronic course of virus hepatitis and fibrosis in liver].

Polymorphic variants of several genes IL4 C(-590)T, IL4RA Ile50Val, TNF G(-308)A were studied for their association with extent of the disease chronization which is marked by hepatic fibrosis stage. Gradual decrease in A allele frequency of polymorphic marker G(-308)A in TNF gene, from patients with weak fibrosis to patients with cirrhosis. Group of patients with weak fibrosis was characterized by higher frequency of A allele (24.5%) comparing with patients with moderate and pronounced fibrosis (13.4%) and cirrhosis (8.7%). Differences in heterozygous genotype frequencies of IL4 C(-590)T were found between patients with cirrhosis (68.2%) and groups of patients with moderate and marked fibrosis (39.1%).

[Immunoregulatory cytokines and chronization of type C hepatitis: matching of clinical and immunological manifestations].

The study demonstrates significant changes of cytokine-producing ability of mononuclear blood leucocytes in type 'hepatitis, correlating with the degree of hepatic lesion. The results showed that various morphologic types of chronic virus type C hepatitis were associated with disbalance in production of pro- and antiinflammatory cytokines, i.e. decrease of tumor necrosis factor (TNF)-alpha concentration and a significant rise of interleukin (IL)-4 and IL-10 concentations, which were the most prominent in cases of severe hepatic fibrosis and high histologic activity of hepatitis. The study established a direct correlation between increase of the ability of mononuclear blood leucocytes to synthesize IL-4, and the progress of the pathologic process.