Аuthors: V. O. Malakhov, V. S. Lychko
Current data concerning the latest developments in the field of cell technology were collected and analyzed et the paper. Prospects of this technology in regenerative medicine were described. Especially promising are techniques guided tissue regeneration and therapeutic angiogenesis, the essence of which lies in the activation of compensatory resources of damaged cells, tissues, circulatory system, stimulating mechanisms of recovery and regeneration, the replacement of lost structures and functions of the organism, organ or tissue.
Acute hypoxia and release a large number of mediators in the area of ischemia is a potent stimulator of angiogenesis. In the course of its own studies have shown that one of the mechanisms of activation of endogenous angiogenesis in the brain of a number of biologically active substances, which are contained in the composition of immunobiological preparation Cryocell-Cryocord. Additional its introduction into the treatment regimen results in significantly more active stimulation of angiogenesis in contrast to the group of animals treated with the standard treatment.
On the model of experimental focal cerebral ischemia in the dynamics of treatment with the addition of immunobiological preparation Cryocell-Cryokord it found that the drug exhibits a pronounced angioprotective properties, prevents capillary stasis, preserves the blood-brain barrier structure, activates the process of angiogenesis in necrotic area by increasing the number of functioning capillaries, and the exchange surface of the capillary bed.
The expressiveness of the vascular response to the 7th day of the experiment, a dense arrangement of the capillaries and the presence of multiple anastomoses indicate activation of collateral circulation in the necrotic area further treated Cryocell-Cryokord.
Keywords: angiogenesis, mesenchymal stem cells, cell therapy, rehabilitation.
Аuthors: I. I. Shkolna, V. E. Markevich, H. F. Tkach, O. V. Hordiienko
Placenta has a number of features that ensure the passage of many biological substances to the fetus as well as the function of barrier for certain substances. According to researchers, it can be used as a marker of unfavorable environmental action.
The aim of study: To identify regulatory indicators of content of essential trace elements (Fe, Cu, Co, Zn, Mg, Mn) in placenta of women which born healthy full term neonates. We also obtained ratios between the essential trace elements that can be used as a normative. We investi-gated the correlation between these microelements in placenta during physiological pregnancy on 37–41 week of gestation.
We have studied the contents of essential trace elements (Fe, Cu, Co, Zn, Mg, Mn) in placenta of women with physiological course of pregnancy.
For the determination of trace elements in placenta used atomic absorption spectrophotometer C-115 M1, equipped with a computer console to automatically calculate the microelements content producing by JSC «Selmi» (Ukraine).
We investigated the concentrations of trace elements in placenta (Fe = 79,91 ± 8,94 mg/g, Cu = 0,83 ± 0,04 mg/g, Co = 0,55 ± 0,2 mg/g, Zn = 45 ± 6,89 mg/g, Mg = 12,22 ± 0,92 mg/g, Mn = 0,73 ± 0,05 mg/g) and proposed the ratio of essential trace elements for using in practice (Fe/Cu=98,84 ± 12,84, Fe/Co = 6185,11 ± 3709,65, Fe/Zn = 2,11 ± 0,38, Fe/Mg = 7,12 ± 1,04, Fe/Mn = 113,25 ± 13,97, Cu/Co = 51,28 ± 27,83, Cu/Zn = 0,024 ± 0,004, Cu/Mg = 0,07 ± 0,007, Cu/Mn = 1,18 ± 0,09, Co/Zn = 0,02 ± 0,01, Co/Mg = 0,04 ± 0,016, Co/Mn = 0,68 ± 0,25, Zn/Mg = 4,11 ± 0,797, Zn/Mn = 64,46 ± 10,51, Mg/Mn = 17,3 ± 1,72). It was noted that a moderate positive correlation between the content of copper and zinc in placenta existed.
Positive correlation of medium strength of content of copper and zinc in placenta was observed. We investigated indicators of content and balance of essential trace elements in placenta of women which born healthy full term neonates. These results should be used as normative.
Keywords: trace elements, placenta, fetus.
Аuthors: O. S. Chynyak, O. I. Kolenko, M. I. Dyachenko
Introduction. In the recent years, the increased number of nervous system diseases has been noted in Ukraine, especially among working-age population. Nervous system diseases ranked fourth among occupational diseases. The ways to prevent and reduce the incidence are early diagnosis and timely preventive maintenance that will keep highly qualified, experienced professionals. An important role for periodic medical examinations aimed at: early detection and early signs of general industrial-caused diseases, dynamic monitoring of workers' health in terms of harmful and dangerous factors of production and the labor process.
Purpose. The main purposes of the research are to identify and to analyze the factors that affect workers at machine-building enterprise, and research of modern methods of prevention and measures to reduce occupational diseases.
Materials and Methods. The research was conducted at the 4th regional clinical hospital department of preventive examinations. There were about 12 000 employees at Public Joint Stock Company “Sumy NPO” in 2014. 6866 workers worked in hazardous conditions that represented 57.21 % of the total number of employees. It was determined that the most common factors that affect engineering company’s employee are: vibration, great physical overload, forced posture fixed, constant load on different parts of the spine, and adverse microclimatic, traumatic factors. To clarify the features of the health status and changes in the nervous system of workers under the influence of a complex environment factors in-depth survey of 250 employees was carried out: 100 boilermakers (group 1), 70 blacksmiths (group 2) and 80 crane operators (group 3). Age of the patients-boilermakers ranged from 22 to 62 years, averaging – (45.3 ± 0.8) years.
Discussion. According to the results of periodic medical examinations of workers employed in a harmful and hazardous working environment in 2014, the structure of neurological diseases in the first group (boilermaker) was: angioneurosis upper extremities – 20 %, osteochondrosis of the lumbosacral spine – 12 %, diseases caused by circulatory disturbance of the brain – 7 %, of those 2 % – the consequences of brain stroke, 1 % – post-traumatic neuropathy median and radial nerves. In the second group (blacksmiths): degenerative lesions of the lumbosacral spine – 14.29 %, angioneurosis upper extremities – 8.6 %, degenerative lesions of the cervical spine – 4.3 %. In the third group (crane operators): osteochondrosis of the cervical spine – 18.7 %, diseases caused by circulatory disturbance of the brain – 7.5 %, osteochondrosis of the lumbosacral spine – 6.3 %. In the structure of neurological diseases in engineering industry workers, a dominant position among CNS diseases occupy: degenerative lesions of spine, chronic brain ischemia, angioneurosis upper extremities. Prevention must include improved system of measures aimed at preserving and improving the health of employees. Measures should include comprehensive, organizational, technical, medical, and rational use of work and rest as well as individual and collective organization of nutrition.
Keywords: occupational diseases, hand-arm vibration, machine-building environment, crane operators, boilermakers, blacksmith.
Аuthors: V. V. Minukhin, N. I. Kovalenko, T. M. Zamazii, I. V. Novikova, G. P. Taranenko
Actuality: There is a change of the general range of infectious agents and their sensitivity to antibiotics. Besides increasing role of opportunistic fungi most of all fungi of the genus Candida in the pathogenesis of infectious diseases of ENT organs is found, and increasing number of strains of the genus Candida fungi resistant to many antifungal preparations is noted.
Objective: studying of the species composition of microflora in ENT pathology and determination of its susceptibility to antimicrobial agents.
Materials and methods: Bacteriological research of various clinical materials from 347 patients with infectious diseases of ENT organs is conducted. Microbiological examination included an isolation of pathogens, identification by morphological, cultural and biochemical properties, determination of the sensitivity of microflora to antibiotics by a diffusion method in agar (the method of standard discs).
Results and discussion: The study found that the leading role in the etiology of infectious disorders of the ear, nose, throat belonged to streptococci of viridans group, S. aureus, S. epidermidis, S. anhemolyticus and fungi Candida species. The greatest sensitivity of all isolated strains was shown to cephoperazone and ciprofloxacin. Tigecycline, ceftriaxone, cephepime and meronem revealed high activity against all bacteria except E. faecalis. Proportion of Candida species was 22.9 %, and 85.8 % of the strains isolated from the nasopharynx, and 81.8 % of the strains isolated from the external ear have been presented in association with the bacteria. 82.5–98.4 % strains were resistant to azoles and amphotericin. Isolated strains of fungi have shown the greatest sensitivity to nystatin.
Conclusions: The obtained data confirmed the requirement to determine the most significant pathogenic flora, which causes diseases of the ENT organs and the respiratory tract organs, its sensitivity to antibiotics, monitoring of resistance at the level of the individual patient, as well as at the regional and country level.
Keywords: microflora of upper respiratory tract, sensitivity to antibiotics, upper respiratory tract infections.
Аuthors: V. V. Krasivska, O. V. Stasyshyn
The purpose of the study was to establish the causes of hemorrhagic syndrome in patients and develop the laboratory diagnostics algorithm of coagulative haemostasis with the help of two groups of correctional tests, screenings and specification diagnosis tests.
Materials and Methods: The subject of the research constitutes 61 patients with hemorrhagic syndrome, who contacted us to be diagnosed. All the patients underwent coagulative screenings. The research includes patients with isolated prolonged activated partial thromboplastin time (APTT), which indicates a disorder of the internal mechanism of trombogenesis system due to a deficiency or inhibition of coagulation factors. In order to identify disorders in the coagulation systems in all the patients, two groups of correctional tests were carried out, which were based on APTT - interchangeable test and screening test to identify the presence of inhibitors for coagulation factors. The purpose of the interchangeable tests was to determine the APTT after mixing the test plasma at a ratio of 1:1 with the control (normal) plasma, with the deficient factor FVIII and the deficient FIX plasma separately.
To differentiate the deficit factor with the pathological inhibitors of coagulation system, a screening test on inhibitors was carried out: the APTT mix was compared with normal plasma and test plasma at a ratio of 1:1, when the components were incubating separately (mix 1), and as a 1:1 mixture of the test and normal plasma at 37 ºС for 60 minutes (mix 2). To determine the inhibitor type we analyzed the availability of correction in mix 1 and mix 2 and assessed the accuracy of the difference in indicators within the group. All the patients underwent the diagnosis specification tests (FVIII, FIX, von Willebrand factor (vWF:Rco), quantity measurement of inhibitor titres and lupus anticoagulant presence).
Results and discussion: Among 61 patients with hemorrhagic syndrome and isolated prolonged APTT 34,4 % were diagnosed with hemophilia A, 11,5 % with hemophilia B, 13,1 % with hemophilia A with inhibitor of blood coagulation factor VIII, 6,5 % with acquired hemophilia A, 1,6 % with acquired hemophilia B, 4,9 % with von Willebrand disease and 27,9 % with anti-phospholipid syndrome (APS). The algorithm which includes combining two types of correctional tests, mixing tests and pathological coagulation inhibitor screening test was developed for laboratory diagnostics of coagulopathies. Firstly mixing tests are carried out in patients with hemorrhagic syndrome and isolated prolonged APTT. The correction of the clotting time after mixing the test plasma with the normal plasma indicates the deficit of clotting factors and absence of the immediate autoimmune type II inhibitor. After normalization of APTT with the deficient FVIII plasma one should proceed assay of FIX and after normalization with the deficient FIX plasma - with the assay of FVIII and vWF:Rco. In case of correction of all the interchangeable probes it’s vital to indicate the FXI activity because it is present in normal, deficient FVIII and deficient FXI plasma. Low level FVIII shows presence of hemophilia A, FVIII and/or vWF:Rco – presence of von Willebrand disease (I, III type), FIX – presence of hemophilia B, F XI – presence of hemophilia C. Little or no correction of prolonged APTT in all three interchangeable probes allows us to suspect with the high probability type II inhibitor (acquired against clotting factors or LA). In this case suspicion on resistance to a replacement therapy in patients with hemophilia A, B it is advisable to proceed with the second group of correctional tests-screening test on inhibitors. The difference between the two mixes is > 2 sec and the correction in mix 1 and mix 2 is absent shows the influence of the immediate type II inhibitor of the clotting system. Further differential diagnostics is based on LA identification, which can suppress phospholipid-dependent coagulation reactions. It’s a well-known fact that LA is hardly ever accompanied by bleedings, which allows to clinically differentiate LA from spontaneous inhibitors with immune coagulopathy, which is accompanied by life threatening bleedings. In case LA is negative it is advisable to proceed with the assay FVIII, FIX, FX. If the level of one of the factors is low it is necessary to identify the quantity of inhibitor antibodies. Inhibitor titre > 0.6 BU/ml indicates the presence of acquired immune coagulopathy.
Conclusions. The researched algorithm, which corresponds to the needs of a specialized coagulative laboratory, allows diagnosing the deficit of factors, the differentiation of the progressive type I alloimmune inhibitor with immediate autoimmune type II inhibitor and a decrease in the time of diagnosis specification.
Keywords: hemophilia, inhibitor, APTT, acquired immune coagulopathy, lupus anticoagulant, diagnostic algorithm.
Аuthors: V. A. Kapustnik, O. V. Istomina
Introduction. In the structure of therapeutic pathologies and occupational lung disease, chronic obstructive pulmonary disease (COPD) takes one of the leading places. Quite frequently an association was found between COPD and hypertension. COPD combined with hypertension has its own characteristics, due to the close functional relationship between hemodynamic and respiratory systems. Works of many authors devoted to study of biogenic elements indicate the important role of providing a balanced body tissue by iron, magnesium, phosphorus and calcium for normal course of numerous metabolic reactions and physiological functions. The study of metabolic disorders of biogenic elements mechanisms remains relevant for understanding of the causal relationships of this comorbid pathology.
Purpose. The aim of the study was to identify the most informative indicators for the diagnosis of chronic obstructive pulmonary disease (COPD) in combination with hypertension by studying the content of biogenic elements in the blood plasma.
Materials and Methods. According to the design of the study we examined the activity of biogenic elements in patients with COPD combined with hypertension (main group), in which 55 patients were included; in patients with isolated COPD (control group), which consisted of 45 patients and a group of healthy subjects (control group), which included 45 patients. The average age of all three groups of patients was 55.4 ± 10.7 years. The biogenic elements content in the blood serum was investigated biochemically. Statistical analysis of the results of experimental studies was carried out using a computer application package for the processing of statistical information Statistica 6.1 (StatSoft, Inc., the USA). As a critical significance level there was accepted p < 0.05 when testing the statistical hypotheses.
Discussion. Patients with chronic obstructive pulmonary disease, especially chronic obstructive pulmonary disease in combination with hypertension demonstrated a violation of the exchange of biogenic elements. The nature and extent of violations of the exchange of nutrients can be considered as a diagnostic criterion for determining the state of the energy and mineral metabolism in patients with this pathology, and allows you to predict the severity of chronic obstructive pulmonary disease with concomitant hypertension. Informative and diagnostically meaningful parameters for the diagnosis and determine the severity of chronic obstructive pulmonary disease in combination with hypertension may be high levels activity of iron and calcium.
Keywords: chronic obstructive pulmonary disease, hypertension, biogenic elements.
Аuthors: V. V. Boyko, K. V. Kharchenko, S. O. Savvi
Diaphragm and liver are common sites of primary and recurrent ovarian tumor lesions. Such cases represent tumor’s biological features. Optimal cytoreduction is the aim both at the primary and subsequent surgery due to its survival improvement effect.
Purpose: to investigate safety and effectiveness of surgical treatment of recurrent ovarian tumors localized on the liver and diaphragm.
Materials and methods. The data of eleven patients treated in the State Establishment « V. T. Zaitsev Institute of General and Emergency Surgery of Academy of Medical Sciences of Ukraine» during January 2001 – December 2010 was included in the current study. Optimal cytoreduction was achieved during primary surgery in all cases. Surgical treatment for recurrent ovarian tumor included stripping of the diaphragm and any liver surgery.
Results. Diagnosis and surgical treatment of synchronous recurrent ovarian tumors in the liver and diaphragm were performed at a mean age (61.13 ± 5.12) years (48–70 years). The median duration of disease-free period was 23 months (6–124 months). Median serum CA-125 level was 151 U/ml (43–1120 U/ml). Preoperatively diaphragm lesion was diagnosed in 7 (64 %) cases. In 4 (36 %) cases tumor was an intraoperative finding. There were no cases of isolated lesions of the left hemidiaphragm. Recurrent tumors in the liver were localized in one lobe in 9 (82 %) cases, in two – 2 (18 %). Number of foci in the liver: 1–6 (55 %) 2–4 (36 %) 3–1 (9 %). Diameter < 5 cm was found in 8 (73 %) cases, ≥ 5 cm – 3 (27 %). The median diameter was 3.8 cm (1–6.3 cm). Surgical interventions performed on liver: wedge resection (n = 2; 18 %), segmentectomy (n = 6; 55 %) bisegmentectomy (n = 2; 18 %), lobectomy (n = 1; 9 %). The number of diaphragm tumor lesions (including bilateral) was 1 (n = 5; 46 %), 2 (n = 3; 27 %), 3 (n = 1; 9 %), 4 (n = 1; 9 % ), 5 (n = 1; 9 %). The median diameter of the largest recurrent tumor on the diaphragm was 2.8 cm (1–4 cm). Postoperative complications occurred in 2 (18 %) patients. Complications did not affect the duration of hospitalization and dates for adjuvant therapy. All patients received chemotherapy after surgery. The level of postoperative mortality was 0 %. The median overall survival after secondary cytoreduction was 24 months. (9–89 months), 5‑year survival rate – 27 %. CA-125 serum concentration, size, number and location of secondary tumors of the liver and the diaphragm did not correlate with survival rates.
Discussion. Diagnosis of synchronous secondary lesions of diaphragm and liver should be improved as well as technical aspects of the combined surgical interventions. It is important to provide further investigations to individualize indications for their implementation.
Keywords: thyroid cancer, biomineralization, immunohistochemistry, markers, apoptosis, osteopontin.
Аuthors: O. S. Solonovych, L. L. Chebotariova, N. V. Kadzhaya, A. I. Trеtiakova
Objective: Determine the criteria of cognitive impairment objectivization in patients with a mild cranio-cerebral injury.
Materials and Methods: 70 patients aged from 18 to 45 who suffered from a mild brain concussion or a brain contusion were examined(GCS 13-15). 40 healthy persons of the same age were examined in the control group. The following methods were used for their examination: a clinical and neurological estimation, neuropsychological testing with the use of various scales, ultrasonography of brain vessels, digital electroencephalography, recording of cognitive auditory evoked potentials.
Results: Complaint frequency in the interim and long-term periods in patients who suffered from a mild cerebro-cranial injury was as follows: complaints of headache – 21.43 %; complaints of memory impairment – 30 %. According to the neuropsychological testing with the help of Montreal Cognitive Assessment (MoCA) and Hospital Anxiety and Depression Scale (HADS), evidence disorder were found in 21.31 % of the patients, memory impairment – in 34.42 %, anxiety and depression – in 26.31 %. Other neuropsychological methods, such as the computerized Lüscher color test, Stroop test, Bourdon test, were less sensitive. According to the cognitive auditory evoked potentials, a significant increase of P3 latency peak was recorded in 42.1 % of the patients; a decrease of evoked potentials amplitude – in 44.72 %. According to the electroencephalography, a tendency for disorganization of the main cortical rhythms in the form of diffuse slowing or acceleration, alpha-rhythm disorganization in frequency and amplitude.
Conclusion: In order to objectivize cognitive impairment in patients with mild cerebro-cranial injuries in the interim and long-term periods for screening purposes, it is appropriate to carry out a neuropsychological testing with the help of MoCA and HADS scales, neurophysiological examination: digital electroencephalography and recording of cognitive auditory evoked potentials.
Keywords: mild cerebro-cranial injury, diagnosis of cognitive impairment, cognitive evoked potentials.
Аuthors: K. A. Stepanchenko
Introduction. Despite the fact that tension-type headache in adolescents is considered an indicator of psycho-vegetative disorders, emotional and affective disorders in this cephalgia, as well as their role in the formation of tension-type headaches in adolescence are not well understood. The role of the school anxiety remains poorly known in occurrence of tension-type headaches in adolescents, despite the fact that many of them complain of a headache in the afternoon, after school.
Purpose. The aim of our study was to investigate the role of reactive, personal and school anxiety in the occurrence of tension-type headaches in adolescents.
Materials and methods. A total of 320 adolescents with tension-type headache have been under study. Research of the level of reactive and personal anxiety by Spielberg`s scale (Yu. L. Hanin modification (1978)), the level of school anxiety (Phillips`s scale) was performed.
Results. The number of adolescents with tension-type headache, with a high anxiety level was 306 persons (95.6 %). 61.9 % of patients had moderate reactive anxiety (р < 0.05), 28.1 % – high reactive anxiety (> 46 points), 66.9 % – high personal anxiety. The average level of reactive anxiety in adolescents with TTH was 40.9 ± 9.1 points; the average level of personal anxiety – 44.6 ± 9.5 points. In healthy teens average level of reactive anxiety was 28.6 ± 5.3, personal anxiety index was 32.3 ± 6.7. Thus, the anxiety level in the control group was significantly lower than in patients with tension-type headache (p < 0.05).
Adolescents with tension-type headache, compared with the control group had significantly increased the frustration of the need to achieve success, as well as the problems and fears in their relations with teachers. It should be noted that adolescents with episodic tension-type headache had increased and high indexes on the scale of examination, fear not match the expectations of others and general anxiety in school. Adolescents with chronic tension-type headache had increased level and adolescents with infrequent episodic tension-type headache – a high level of experience of social stress associated with the complexities of social interactions, especially – with their peers.
Conclusion. It was found that adolescents with tension-type headache have an increased level of reactive, personal and school anxiety, which is most pronounced in adolescents with episodic forms of tension-type headaches. With increasing frequency of episodes of tension-type headache there is increasing frequency of a low resistance to physiological stress.
Keywords: tension-type headache, adolescents, reactive anxiety, personal anxiety, school anxiety.
Аuthors: O. M. Chemych, L. V. Moroz
Introduction. Salmonella is the most common intestinal infection. The disease is topical for Ukraine. The main clinical feature of salmonellosis is intoxication – a complex of symptoms caused by the integrated action of microorganisms and their toxins on the one hand, and the reaction of the human body on the other hand. Dehydration syndrome with the syndrome of endogenous intoxication in clinic of salmonellosis determine the severity of the disease and its prognosis.
Purpose. To establish the effect of the applied treatment regimens in patients with salmonellosis by studying integral, integrative indices of endogenous intoxication and indicators immunoreactivity in different periods of illness.
Materials and methods. 189 patients with salmonellosis were examined in clinical and laboratory conditions. Depending on the resulting treatment all surveyed were divided into four group: SI – receiving basic therapy, SIІ – receiving basic therapy without the antibacterial agent adding researched probiotic, SIII – basic therapy and investigating probiotic SIV – basic therapy and other probiotics.
Results. Hematologic changes were identified and the main clinical and epidemiologic features of salmonellosis were analysed in the acute phase of the disease. Changes of integrative endogenous intoxication indicators point to the disturbances in the immune system of patients – the prevalence of humoral and cellular immunity suppression. Endogenous intoxication and severe inflammatory response were developed as a result of destruction of their own cells, and by the action of bacterial endo- and exotoxins. Delayed reactions dominate over hypersensitivity of immediate type in the acute period, during intoxication. This leads to the launch of allergic mechanisms. Rapid integral, integrative indices normalization of endogenous intoxication and immunoreactivity were observed in convalescents SIII and SII group.
Conclusion. In patients the positive effect was observed when investigated combined probiotic was added to the treatment regimen. In groups SIII and SII quickly normalized integral, integrative indicators and immunoreactivity.
Keywords: salmonella, clinic, integrated indicators, integrative indicators, endogenous intoxication, treatment regimens, probiotics.
Аuthors: I. Makagonov
The article describes the main causes of background diseases of cervix of the uterus, highlights the issues of diagnosis and complex treatment of this pathology, based on a consistent set of examination: colposcopy, cytology, gіstology. The aim of this study was to investigate of the efficacy and safety of using the drug Colpotrophine compared with Methyluracilum after destructive treatment of cervical pathology based on the data of the scientific literature and own research and improve the algorithm for diagnosis of background cervical diseases.
The study involved 60 women of reproductive age who were diagnosed for background diseases of cervix of the uterus. The technique of postoperative preventive maintenance of complications, accelerations reparative processes and quality improvement epithelization is offered at use local destructive methods of treatment of the pathology of cervix of the uterus.
Results of the spent researches testify that the complex approach to the decision of a difficult scientific problem with additional use of Colpotrophine allows to raise efficiency of treatment and to lower frequency recediving.
Colpotrophine demonstrates regenerative properties and promotes complete epithelialization of the cervix. Studies have shown that the drug is well tolerated.
Results of the study can be recommended to include complex examination of patients with background diseases of cervix of the uterus transvaginal echography to diagnose ectopic glands deep cysts that are impossible to detect visually and by colposcopy.
Keywords: background diseases of cervix of the uterus, ultrasound diagnostic, treatment, regeneration, Colpotrophine.
Аuthors: T. I. Kmet’, O. G. Kmet’
Introduction. During the last decade a progressing growth of patients with diabetes mellitus has been marked. Ischemic stroke occupies one of the leading places by the occurrence of complications and mortality of patients with diabetes. The hypoxic-transcription factor HIF-1α is an important promoter to form the mechanisms of resistance to oxygen-substrate deficiency in the cerebral cortex.
Purpose. The objective of the study is to find the peculiarities of HIF‑1α protein reaction to incomplete global cerebral ischemia with reperfusion of various durations in separate lobes of the cerebral neocortex in male rats with experimental diabetes mellitus and to make their comparative analysis.
Materials and Methods. Streptozotocin was injected to two-month male rats to simulate diabetes mellitus. In a part of the animals general carotid arteries were clipped bilaterally at the age of 5 month for 20 minutes, after that blood flow was renewed to achieve reperfusion. To study early results of ischemia-reperfusion a part of the animals were deactivated from the experiment 1 hour after reperfusion period was over, for the delayed results – on the 12th day. According to the coordinates of the stereotaxic atlas the cortex of the frontal, parietal and temporal cerebral lobes was isolated. With the aim to identify cells expressing HIF-1α protein indirect immunofluorescent method was used.
Discussion. The results of the experimental study were indicative of the fact that diabetes mellitus modifies the reaction of antihypoxic HIF‑1α protein in early ischemic-reperfusion period in the cortex of the frontal and parietal lobes, and on the 12th day of the experiment–in all the lobes of the cortex examined.
Keywords: diabetes mellitus, carotid ischemia-reperfusion, HIF‑1αprotein.
Аuthors: Ye. I. Dubovyk, Ye. A. Harbuzova, A. V. Ataman
Introduction. Vitamin K epoxide reductase complex subunit 1 (VKORC1) is integral 163-amino acid long transmembrane protein (18 kDa) which is widely expressed in many organs and tissues of the human and animal organisms and it is necessary for activation of vitamin K-dependent coagulation factors (II, VII, IX, X), anticoagulation factors (Protein C, S, Z) and proteins with anti-calcification properties (Matrix Gla-protein, Gla-rich protein) in the vitamin K cycle. It can be assumed that VKORC1 dysfunction might cause activity reduction of vitamin K-dependent proteins, and thus might lead to thrombosis and vascular calcification. Considering the above mentioned the aim of present work was to perform a case-control study on representatives of both genders of the north-eastern region of Ukraine in order to assess the possible association between VKORC1 gene promoter G-1639A polymorphism with ischemic atherothrombotic stroke (IAS).
Materials and methods. The study group included 170 unrelated Ukrainian patients with a mean age of 64.7 ± 0.73 years who had IAS. The control group consisted of 124 clinically healthy individuals with the absence of cardio-vascular pathologies. VKORC1 promoter G-1639A (rs9923231) polymorphism genotyping was performed using PCR-RFLP (polymerase chain reaction with following restriction fragment length polymorphism analysis) method. Most statistical analyses were performed using Statistical Package for Social Science software (SPSS, version 17.0, Chicago, IL, USA). All statistical tests were two-sided, P < 0.05 was considered significant.
Results. It was shown that ratio of main homozygotes, heterozygotes and minor homozygotes in stroke patients was 39.4 %, 48.8 %, 11.8 % (in control – 34.7 %, 53.2 %, 12.1 %, P = 0.027). Genotypic association between G-1639A polymorphism and IAS was revealed in women after adjustment for covariates of age, BMI, smoking status and arterial hypertension under dominant (Padj = 0.038, ORadj = 2.848, 95 % CI = 1.058–7.665 for G/A and A/A genotypes) and additive (Padj = 0.049, ORadj = 2.888, 95 % CI = 1.006–8.293 for G/A genotype) model. In men significant difference was present only in the crude additive model (Pobs = 0.049, ORobs = 2.240, 95 % CI = 1.002–5.007 for A/A genotype), but was lost after adjustment (Padj = 0.077).
Conclusion. Obtained results suggested that -1639A allele can be a possible genetic risk factor for ischemic stroke in women in Ukrainian population.
Keywords: VKORC1, gene polymorphism, ischemic stroke.