[Brain benzodiazepine receptors in humans and rats with alcohol addiction].

OBJECTIVE: Benzodiazepine receptors (BDR) in synaptosomal and mitochondrial membranes from different brain areas of alcohol abused patients (postmortem) and the brain cortex of male rats (Vistar line) with different preference to alcohol were studied. METHODS: Synaptosomal and mitochondrial receptors of membranes from different brain areas of patients with alcohol addiction and controls were explored using radioreceptor analysis with selective ligands [3H]flunitrazepam and [3H]PK-11195. BDR in the rat brain were studied using [3H]flunitrazepam and [3H]Ro5-4864. RESULTS: An analysis of kinetic parameters (Kd and Bmax) of [3H]flunitrazepam and [3H]PK-11195 binding with synaptosomal and mitochondrial membranes in the human brain showed that BDR was decreased and capacity increased in different human brain areas under the influence of alcohol abuse. The most distinct changes were found in the prefrontal cortex, nucleus caudatus and cerebella cortex. Alcohol abuse induced greater changes in mitochondrial membranes compared to synaptosomal membranes that was consistent with physiological and defensive functions of mitochondrial membranes and CNS under the influence of toxic substances. The affinity of [3H]flunitrazepam and [3H]Ro5-4864 binding with membranes was decreased, but the capacity of receptors was increased in the brain cortex of alcohol-preferring male rats compared to alcohol non-preferring rats. Administration of anticonvulsant meta-chloro-benzhydryl-urea to rats prefer ethanol increased the affinity of BDR.

[Characteristics of oxidative stress in mental maladaptation].

Changes in the balance of pro and antioxidant systems were studied in persons in state of mental maladaptation, developed under the influence of emotional stress. Activation of lipid peroxidation has been revealed associated with increase of amount of malondialdehyde in erythrocytes and blood serum in persons surveyed. Activity of catalase and glutathione peroxidase in erythrocytes in persons in state of mental stress was increased and glutathione preductase, glutathione-S-transferase and glucose-6-phosphate dehydrogenase has been reliably reduced as compared with group of healthy people. Comparative chemiluminiscent analysis of common antioxidant properties of serum of blood of studied groups has also revealed decrease of antioxidant properties of blood under influence of mental stress.

[Therapeutic efficiency of cytoflavine solution for infusion in emergency conditions].

The author reports results of clinical assessment of cytoflavin for injections in the treatment of different pathological condition including critical ones. It was shown that therapy reduces mortality among patients with acute disturbances of cerebral circulation to 4.8-9.6% compared with 11.7-17.1% in controls. Positive dynamic of neurologic status was documented in 79% of the patients with dyscirculatory encephalopathy versus 25% in control. Duration of comatose state decreased 1,7-fold, length of stay in resuscitation and intensive therapy wards 1.8-fold, and frequency of internal complications secondary to the effect of neurotropic poisons 2-fold. Cytoflavin corrected the level of metalloproteides and stabilized antioxidative potential of sera and cerebrospinal liquid in patient with meningitis including that of zoonotic etiology. In the period of post-narcosis rehabilitation cytoflavin restored conscience in 77% of the patients within 20 min. The drug also inhibited pathological alcohol addiction within 5 days after the onset of therapy as apparent from the improvement of intellectual-mnestic status and activization of attention. The frequency of infectious complications in patients with acute surgical abdominal pathology decreased by 5.1% and lethality by 3.6% compared with placebo group. Cytoflavin exhibited cardioprotective action in patients with myocardial infarction, during cardiosurgical intervention, and chronic brucellosis. It had hepatoprotective effect in iatrogenic hepatic conditions as well as ophthalmo- and oto-protective activity.

[Peptic ulcer in patients with neurotic and affective disorders: comorbidity, clinicoendoscopic and psychopathological features, approaches to therapy].

AIM: to study clinicoendoscopic and psychopathological relationships and the course of peptic ulcer (PU) in patients with neurotic and affective disorders and to evaluate the efficiency of psychopharmacotherapy, by applying a comprehensive approach to the treatment of comorbidies. SUBJECTS AND METHODS: The study covered 245 patients aged 43.3 +/- 8.8 years from the Department of Borderline Conditions who had been diagnosed as having duodenal PU and gastric PU with a prevalence of stress-associated neurotic disorders, as well as affective and other ones. Clinical psychopathological and experimental psychological tests and rating psychometric scales were used to evaluate the patients' mental status. Somatic diseases were verified by endoscopic, morphological, and ultrasound diagnostic techniques. RESULTS: Multivariate analysis has revealed a relationship of the phase of an ulcerative process and age to the first manifestations of psychopathology, its duration, and gender. Assessment of psychopharmacotherapy in patients with PU has shown the high efficacy of the antidepressant of coaxil in the treatment of the comorbidity. CONCLUSION: The polymorphism of psychopathological disorders and their trend are determined by the clinical changes in the course of an ulcerative or erosive process. The inclusion of coaxil into the combined treatment regimen for PU in patients with neurotic and affective disorders is expedient and pathogenetically founded at all stages of a follow-up.

[Platelet peripheral benzodiazepine receptors in alcoholism].

The peripheral-type benzodiazepine receptor (PBR) is an transmembrane protein, distinct pharmacologically, structurally and functionally from the central-type benzodiazepine receptor. The kinetic binding parameters of the specific PBR ligand, the PK11195, have been evaluated in platelets from 36 male alcoholic patients in relation to 19 healthy sex-matched controls. A significant increase of mean value of platelet PBR density was observed in patients as compared to the controls (4733 +/- 379 and 3358 +/- 242 fmol/mg proteins, p < 0.005). There are no statistically significant changes in the receptor affinity values in the group of patients.

[Apoptosis of immunocompetent cells in patients with depressive disorders].

A comprehensive evaluation of biological indices has been carried out in 26 patients with depressive disorders and in 20 age- and sex-matched controls. Indices of programmed cell death (apoptosis) in subpopulations of blood lymphocytes and concentration of cortisone in blood serum were determined. Significantly enhanced apoptosis was observed in the lymphocytes of depressive patients as shown by increased percentage of lymphocytes expressing FAS-receptor and cells with morphological changes characteristic of apoptosis (nuclear condensation, vacuolation. Clinical symptoms of depression were concomitant with alterations of cellular link of immunity expressing in the decrease of the total T-lymphocytes (CD3+) number, T-helpers (CD4+) and natural killers (CD16+) as compared to healthy persons. The level of blood serum cortisone was increased in patients with depression. High cortisone values correlated with suppression of cellular CD4+ population and an increase of FAS-receptors expression in patients with depression.

[Arterial hypertension as a psychosomatic problem]. / Arterial'naia gipertoniia kak psikhosomaticheskaia problema.

Current conception of stratification of arterial hypertension (AH) risk comprises a general strategy of its prevention, treatment and prognosis with consideration of personality, medical and social characteristics of the patients. In view of this AH is regarded a psychosomatic problem including somatic, psychic and social aspects. Of importance is AH study in patients with nonpsychotic mental disorders using methods of systemic analysis, multivariate probability models, in particular. The most adequate model is logistic regression. Our study included 1350 patients with borderline conditions. The developed model systems allowed isolation of the most significant somatic, psychic and psychosocial factors which can be applied as additional predictors of AH risk. Also, the results of the analysis may be useful in preventive interventions regarding individual spectrum of AH risk under joint efforts of internists, psychiatrist and psychotherapist.

[Search for biochemical factors implicated in the pathogenesis of alcoholism in different ethnic populations]. / Poisk biokhimicheskikh faktorov, uchastvuiushchikh v patogeneze alkogolizma v razlichnykh étnicheskikh populiatsiiakh.

A Chukotka indigenous population (the Chukchis, Eskimos) craving alcohol was examined. Changes in the levels of endogenous ethanol (EE) and its relation to calcium homeostasis, hypophyseal-adrenocortical hormones (stress) in the body are regarded as a possible role in alcohol motivation and ethanol dependence. The frequency and pattern of alcohol consumption, high alcoholism incidence rates in the family history may consider the Arctic Mongoloids as a group at high risk for alcoholism. Manifestations, such as lost control over the dose used, alcoholic amnesia, occasional use of alcohol poisoning doses with high rates of alcohol dependence, withdrawal syndrome, were noted in more than half the examines. The reproduction accuracy of correlations between the baseline signs was maximizing by factorial analysis. Four major factors (63.3% of complete variability) were singled out, two aspects were found in the system of metabolism and biochemical variabilities: 1) the secretion of cortisol, testosterone and the activity of 2-hydroxybutyrate dehydrogenase (HBDH) contributes to the increase of EE concentrations with the simultaneous decrease in the blood levels of ionized calcium (Ca++) and uric acid (UA). On the contrary, higher Ca++ and UA concentrations directly or indirectly inhibit hormones and the functional activity of the adrenal cortex, testes and lower the levels of EE, some enzymes, and total protein, 2) Calcitonin (CT) and parathyroid hormone (PTH) seem to be factors favouring the activation of insulin that enhances the membranous transport not only of glucose, but some other saccharides together with EE. The findings suggests that there is an intricate impact of balance ratios in the scheme wherein Ca++ is likely to act as a link between the stimulus and secretion of hypophyseal, adrenal, thyroid, parathyroid hormones, on the one hand, and EE concentrations. A relationship of pleiads reflects a common process of the integration of neurohumoral mechanisms and the regulation of calcium metabolism. The findings serve as a basis for further studies of different links of the pathogenetic mechanisms responsible for the development of alcoholism in terms of ethnic features.

[Dynamic estimation of mental health in native and newcomer population of the Siberian North]. / Dinamicheskaia otsenka psikhicheskogo zdorov'ia korennogo i prishlogo naseleniia Severa Sibiri.

Clinical and epidemiological studies of the population (the indigenous, the aliens, the migrants) in the Siberian North have shown it promising to develop a regional aspect of modern psychiatry and narcology. There is a high prevalence of borderline states and alcoholism among the natives and migrants. Specific features of the clinical picture of many types of borderline abnormalities have been found. The traditional criteria are of relative significance in the determination of the mental health and it is essential to revise the existing strategy of specialized psychiatric and narcological care.

[The characteristics of the interferon system parameters in typologically different groups of patients with borderline mental disorders during treatment]. / Kharakteristika nekotorykh parametrov sistemy interferona v tipologicheski razlichnykh gruppakh bol'nykh s pogranichnymi psikhicheskimi rasstroistvami v protsesse lecheniia.

Lymphocyte gamma-interferon production and levels of serum interferon were studied in 94 patients with borderline psychiatric disorders on treatment. It was shown that parameters of interferon system in the acute disease period and their dynamics through the treatment depend on typological features of personality and initial level of interferon production. The patients with aggressive features of personality in acute disease exhibit significantly higher levels of serum interferon than those in patients with submissive features which drop after recovery. The same tendency occurred in hysterical patients (hystero-expressive and hystero-impressive types). These findings may be due to different reaction of immune system to chronic emotional stress in different types of personality.

[Epidemiology, clinical aspects and prevention of borderline conditions in the regions of Siberia and Far East]. / Epidemiologiia, klinika i profilaktika pogranichnykh sostoianii v regione Sibiri i Dal'nego Vostoka.

The problem of borderline conditions in the population of Siberia and the Far East is analyzed from the standpoint of a comprehensive multidisciplinary approach. The authors established the indicators, close to the real ones, of the prevalence of borderline disorders, exceeding many times the formal statistic data. Evidence is given of the role of certain personality parameters (rigidity, anxiety) and biological factors (the status of the immune and hormonal systems) in the formation and course of borderline conditions. The clinical studies carried out over time made it possible to specify definite stages in the development of borderline pathology. 3 stages were delineated: initial disorders or reactions; neurotic or neurosis-like conditions; neurotic or pathological developments of the personality. The authors demonstrate imperfection of the existing systems of psychiatric aid in respect to patients with borderline disorders and provide evidence for the necessity of organizing psychiatric services outside dispensary aid. Novel organizational models (the center for borderline conditions, the center for mental health care at industrial enterprises, municipal psychohygienic consultation) developed by the authors are provided as prognosis. These structures made it possible to enhance the efficacy of prevention and treatment of borderline conditions.

[Systematic approach to the analysis of borderline neuro- psychological disorders in oncological practice]. / Sistemnyi podkhod k analizu pogranichnykh nervno-psikhicheskikh rasstroistv v onkologicheskoi praktike.

To study syndrome formation in the course of the development of neuropsychic disorders in oncological practice, a total systems approach including an original model of psychosomatic correlations was used. Two groups of patients, namely of those suffering from the cancerophobic syndrome without any real oncologic pathology and of those with neuropsychic diseases that developed because of an oncological disease are compared. Analysis is made of the hierarchy and mechanism of interaction of the three factors mainly responsible for the syndrome formation: ++somato-organic, constitutional typological and ++psycho-sociogenic depending on the character and stage of disease. The authors indicate areas where the approach may find practical application: diagnosis, the design of prognosis, and pathogenetic therapy of the neuropsychic disorders under consideration.

[Dysontogenesis of the brain of the progeny born to mothers drinking alcohol during pregnancy]. / Dizontogenez golovnogo mozga potomstva materei, upotrebliavshikh alkogol' v period beremennosti.

A study was made of the development of the brain from 44 embryos (5-12 weeks) and 1 fetus (14 weeks) obtained from mothers who used alcohol during pregnancy. 16 cases made up the control group. In 34 cases out of 45 (75.5%), deviations in the development of the brain were established and distributed into the three degrees of gravity: mild, moderate and severe. 11 variants of brain pathology are described. Deviations in the formation of brain walls and disorders of the development of the cortical lamina occurred most frequently (70.6 and 57.9%, respectively). In alcoholic mothers, brain pathology in their progeny was revealed in 100% of cases. Provided they used alcohol systematically and frequently, brain pathology was identified in 83.3% of cases, in systematic rare use of alcohol in 77.3%, and in episodic use of alcohol in 28.5% of cases.

[Various results of the study of medico-biological aspects of alcoholism in Siberia and Far East]. / Nekotorye itogi izucheniia mediko-biologicheskikh aspektov alkogolizma v Sibiri i na Dal'nem Vostoke.

To study the dynamic changes in alcohol abuse, a new methodological approach has been developed which implies staged realization. Stage one was aimed at the search for integral clinical-dynamic characteristics as well as social and psychological properties to make identification of the clinical phenotype reliable. Stage II--at introduction of integral constitution-morphology indicators representative of the disease predisposition-stability. The analysis of medicosocial characteristics for the last 8 years has been performed at Stage III. Calcium homeostasis and related hormones and enzymes were evaluated at Stage IV. The data obtained permitted identification of a complex of structural manifestations underlying alcohol embryopathy of the brain.