Authors: Romanjuk A. M., Moskalenko R. A., Rieznik A, V., Gapchenko A. V.
Resume. In thyroid gland calcifications are found in benign as well as in malignant pathology, which are diagnosed by ultrasound investigation of the organ. The resulting diagnostic information about calcified objects in the thyroid gland are missed often by physicians or they have minimal clinical significance (Khoo M.L. et al, 2002).
The aim of the work is to analyze the scientific literature data for establishing the spread, mechanisms of origin and diagnostic value of pathological biomineralization in the thyroid gland.
The patient's age, sex, size and histological tumor affiliation, the presence of metastatic affection outside the thyroid gland, lymph node status are the significant markers for prognosis in patients with thyroid cancer (TC) (Bai Y. et al, 2008). Calcification is detected the most often by papillary thyroid carcinoma (PTC) among all thyroid diseases. However, the clinical value of calcification, including the clinical manifestations’ correlation, the impact on patient’s survival and molecular mechanisms, which are responsible for tumor tissue calcification, are unidentified. Thyroid calcifications were divided psammoma bodies (PBs), stromal calcification and bone tissue formation (ossification), in the works of Bai Y., et al, (2009), based on clinical pathological features of biomineralization. Most of authors consider the PBs presence as diagnostic feature of PTC. PBs are characterized as spherical calcified foci, that are constructed by concentric plates (LiVolsi V. et al., 2004, Johanessen J.V. et al., 1980). There are different views about the origin of PBs. Johanessen J.V. et al., (1980) consider PBs as a result of dystrophic tumor thrombuses’ calcification in the lymphatic and blood vessels’ lumen. According to the views of other authors PBs are formed by the intracellular calcifications in viable cells as the nidus. Cell degeneration and necrosis, which lead to the disappearance of tumor cells, are found only around the PBs, but not around predecessors. Based on these facts, the authors present the PBs as an active biological process, that leads to the death of tumor cells and prevents their growth and spread (Das D.K, 2009). There is also an original hypothesis of the PBs origin in the tumors of thyroid gland and ovaries, in which the participation of gram-negative nanobacterium (Chlamidia) in the biomineralization process are proved, these bacteriums are capable for calcium precipitation (Hudelist G. et al., 2004). Ossification or bone formation were found in the cases, in which bone matrix and osteocytes were identified (Bai Y. et al, 2008). All calcifications, that didn’t approach to the definitions of PBs and ossification, were considered as stromal calcification, including also psammosa like calcifications - round without a layered structure but with uneven borders. Stromal calcification is caused by calcium phosphate deposition in fibrous stroma. Bone formation proteins (bone morphogenetic protein - BMP) 1, 2, 4, 9 and 11, osteopontin, ALK1, TGF-β1 take part in pathological processes of thyroid gland biomineralization at the molecular level.
Thus, signs of pathological biomineralization (calcification) may be an important differential diagnostic criteria of thyroid gland tumors as during ultrasound, and pathohistological study. This touchs on especially patients with solitary calcified node, calcification of neck lymph nodes, microcalcifications in older patients (over 45 years) and coarse node calcification. Pathologists should pay particular attention to the PBs in the thyroid gland, which are not associated with tumor pathology, because it may be a sign of hidden PTC (microcarcinoma) or metastasis from the opposite gland lobe.
Key words: thyroid gland, calcification, psammoma bodies, ossification, diagnostic
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Authors: Mikheytseva I. N.
Purpose: tostudy the possibility oftheformationof symptoms of primary glaucoma - elevated intraocular pressure and morphological changes of the optical apparatus of the eye - in agedanimals with introduction of the stress- hormone adrenaline.
Material and methods.
The study is conducted on 40 rabbits age 2-3 years, and 25 rats age 12-15 months. Glaucoma is modeled byinravenousinjections of 0.18% solution of adrenaline hydrotartrate in rabbits and intraperitoneal injections in rats, developed by us for the scheme, every 1st, 3rd the 5th day of the week. Unified single dose of the drug was calculated depending on weight from 12.5 to 25 mcg/kg in rabbits and from 10 to 15 mcg/100g in rats.
Control of intraocular pressure (IOP) is carried out before the introduction of adrenaline application with Maklakov' tonometer (the plunger weighing 7.5 g in rabbits and 2 g in rats) under local anesthesia. Histo - morphological studies of tissues of the animal enucleated eyes held on preparations stained with hematoxylin - eosin. For statistical evaluation of the experimental data we use ANOVA for repeated measurements.
Repeated systemic injections of adrenalin in rabbits and rats cause them to have a significant increase in IOP. In the period of drug administration, this increase is in rabbits 25%, rats - 52%. After termination of model induction with adrenaline IOP continues to grow. In rabbits, this index exceeds the original value by 38% after 6 months, after 12 months it increases by 57%. In rats, 10 weeks after injection of adrenaline, IOP increases by 72% and remains at this level after 20 weeks of observation. ANOVA for repeated measurements using a linear mixed model type shows that in the experiment with the simulation of glaucoma, extended in time, for the formation of high IOP does not matter the time factor, but adrenaline is essential factor for inducing pathologic process.
Histo-morphological studies reveal degenerative changes in the blood vessels of the eyes of experimental animals, it is accompanied by degeneration of the ganglion layer of the retina and tissues of the optic nerve with a deep excavation of the disc.
Chronic adrenal stress, induced by repeated application of adrenaline, is a triggering mechanism of primary glaucoma. On the basis of hyperadrenalinemiya by prolonged systemic injections of adrenaline in agedexperimental animals - rabbits and rats- we reproduce the main features of glaucoma - resistant ocular hypertension and specific structural changes of the nervous apparatus of the eye–retina and optical nerve structure.
Key words: glaucoma, model, adrenaline, stress, intraocular pressure, retina.
Authors: Hassan Ali Al-Saadi
Colorectal cancer (CRC) is the third most common cancer diagnosed, and is associated with high rates of propagation and mortality for both men and women. Aimed to to analyze impact of presence of T-bet, Foxp3 and CD8 on colorectal cancer. During the period 1/October/2013 to 1/March/2014, fifty patients with colon cancer (14 female and 36 male) (7-75) years were taken from (Al-Hussain Hospital City/Kerbala, Digestive and Liver Disease /Education Hospital Medical City Baghdad and Teaching Oncology Hospital /Baghdad Medical City/ Baghdad /Iraq).Immunochemical studying of T-bet, Foxp3 and CD8 of colorectal biopsies by using DAKO Company/Denmark. There was a significant increase (p≤0.001) in the concentration of T-bet, Foxp3 and CD8 respectively in patients male compared with female, also there was a significant variance (p≤0.001) in the three age groups from (7-20), (21-40) and (41-75) in the levels of T-bet and CD8, whereas a significant difference (p≤0.05) in the concentration of Foxp3 in the three age groups. This study proved functional role of T-bet, Foxp3 and CD8 in cell-mediated immunity.
Key words: T-bet, Foxp3, CD8, Colorectal cancer.
Authors: Savchenko І. М.
Introduction. Pathogenesis of the leiomyoma includes a thorough update of the tumor microenvironment. This process also involves the destruction of intertissue barriers and tumor neoangiogenesis, provided by the Zn-containing enzyme of the matrix (metaloproteіnaza–1 MMP-1). The polymorphism of MMP-1 gene might be closely connected with the contraction and further progression of this pathology.
Purpose. Detect the genotypes frequency by 1G/2G–1607 polymorphism of the MMP-1 gene in women, who suffer leiomyoma and have additional disorders.
Materials and Methods. We have used the venous blood of 108 women diagnosed with leiomyoma (average age was 47,82 ± 6,6 years) and the venous blood of 84 women, without this disease (average age was 69,75 ± 8,4 years). The detection of 1G/2G–1607 polymorphism of the MMP-1 gene was conducted with the help of polymerase chain reaction method with further restriction fragments length analysis while allocating them by electrophoresis in agarose gel. The AluI restriction enzyme was used for the restriction analysis. Statistical data processing was carried out with the help of SPSS-17 software package. In addition, the differences were determined by χ² criterion. Values with Р<0,05 were accepted as accurate.
Results. In women, who have chronic obstructive pulmonary disease and 2G/2G genotype, leiomyoma develops more often than in the 1G allele carriers (Р=0,035). Between patients with the chronic pyelonephritis, leiomyoma is more common for carriers of the 2G / 2G genotype (Р=0,034). In patients who have hypertension and 2G/2G genotype, risk of leiomyoma is higher than in carriers of the 1G / 1G genotype (Р=0,042). During the comparison of the 1G / 2G genotypes frequency in women, who had any disorders with cerebral or coronary blood circulation, the significant difference has been detected only in patients with leiomyoma, who didn’t have any interference with the blood flow (Р=0,030).
Conclusion. The connection between 1G/2G polymorphism and leiomyoma progression is particularly noticed in women, diagnosed with the chronic obstructive pulmonary disease, hypertension and patients, who do not have cerebral or coronary blood circulation failure.
Key words: matrix metaloproteіnaza–1, single nucleotide polymorphism, leiomyoma, pyelonephritis, hypertension.
Authors: Lukavenko I. M., Andriushchenko V. V., Yazykov O. V.
With the development of modern technologies committed step in the study of the pathogenesis of breast tumors. However, despite the advances of science, diagnosis of benign mammary dysplasia remains difficult. A promising direction is to develop methods by which a forecast of possible pretumor pathology. Important in the progression of cell proliferation in the mammary gland is the receptor cell state as a violation of the expression of steroid hormone receptors is associated with risk of breast cancer. To date, there are no clear criteria for the expression of estrogen receptor interactions with the degree of proliferation in the mammary gland during its dysplasia. Meeting this challenge will not only help to explain the pathogenesis of breast dysplasia, but also help to build the circuit of individual treatment, justify the appropriateness of hormone therapy. The level of expression depends on many factors including the structure of the gene that encodes it. Nowadays many published papers about the association of single nucleotide polimorfima PvuII gene EsRα with breast pathology. However, the information collected mainly in the study of breast cancer. The question of influence on the development of PvuII mammary dysplasia remains relevant.
Purpose - to analyze the association PvuII polymorphism of the gene EsRα with the degree of proliferation and expression of EsRα in breast tissue with its benign dysplasia.
To achieve the goal of an analysis of surgical treatment of 84 patients with benign mammary dysplasia. Separately studied 134 morphological sample of breast tissue in operated patients. Used molecular genetic, immunohistochemical methods. Statistical analysis was performed using the program SPSS-17. Thus the significance of differences was determined by the χ2-test. The value of P <0,05 was considered significant. It is shown that there is a connection between the PvuII polymorphism EsRα with different levels of expression EsRα(χ2 =51,041; P < 0,0001) and the degree proliferation(χ2 =43,142; P < 0,0001) in breast tissue with its benign dysplasia. This information may be useful to clinicians considering the fact that the proliferative changes in the breast are considered as background for the development of cancer, and (С/С) homozygous for the PvuII polymorphism of the gene EsRα - a reliable indicator of increased proliferation with a penchant for atypia in breast tissue when it dysplasia.
Keywords: estrogen receptor alpha, benign mammary dysplasia, genetic polymorphism, genetic medicine.
Authors: Grek A. V., Savenko I. I., Sasiuk O. S.
Introduction. Cardiovascular system diseases take one of the first places in the structure of mortality and disability in the world and Ukrainian population and are the most spread diseases. In the pathogenesis of ischemic heart disease theendothelial dysfunction plays an important role, and the increased level of homocysteine is one of its etiological factor. Increase of the blood homocysteine level may be caused by genetic predisposition, in particular, C677T polymorphism of methylenetetrahydrofolate reductase gene (MTHFR). Therefore, the purpose of this research was to compare the frequency of C677T polymorphism of MTHFR gene in the practically healthy and among patients with IHD with ACS manifestation.
Materials and methods of investigation. 161 patients with IHD and ACS manifestation, who were treated in Municipal Company of Sumy Regional Council “Sumy Regional Cardiology Clinic” from January till July 2012, were examined. Control group consist of 87 almost healthy humans. ACS had been diagnosed according to Decree №436 MPH Ukraine.
The determination of the allelic polymorphism 4th exon of MTHFR C677T gene (rs1801133) was performed by the method of chain polymerase reaction with following analysis of the restriction fragments lengths.
Visualization of DNA after electrophoresis was made using transiluminator (“Biokom” Russia), in the scientific laboratory of molecular genetic studies at the Sumy State University. Statistic analysis was performed using the programme SPSS – 17. The reliability of differences determined by χ2 – Pirson criterion. The value P – <0,05 was considered possible.
Discussion. The frequencyof C/C, C/T and T/T genotype by C677T polymorphism of MTHFR gene among almost healthy humans was: 47,1 %, 42,5 %, 10,4 %, and in patients with ACS 52,7 %, 35,3 %, 12 % respectively. Absence of the statistic differences in the distribution of genotype depending on sex was proved. Investigation of the distribution of genotypes by C677T polymorphism of MTHF gene depending on age surveyed, showed, that in groups of patients of young, middle and elderly ages the statistically reliable difference is absent (P=0,554,P=0,876, P=0,320 respectively).
Availability of statistically reliable difference was found in control group and senile age patients with ACS (P=0,041). The association of T/T gene by investigated polymorphism with severe course ACS was detected.Thereby, distribution of genotypes polymorphism of MTHFR gene statistically did not differ in control group and in patients with ACS but was associated with the severity of its course.
Keywords: coronary artery disease, acute coronary syndrome gene polymorphism, methylentetrahydrofolate reductase.
Authors: Orlovskyi V. F., Kuchma N. G., Orlovskyi O. V.
Plasma homocysteine levels in patients with nonalcoholic fatty liver disease. The purpose of this investigation was to determine the level of homocysteine blood plasma in patients with nonalcoholic fatty liver disease. In investigations took part 63 patients with nonalcoholic fatty liver disease. Patients were divided into two groups. The first group( I group) included 30 nonalcoholic liver steatosis and second group (II group) included 33 patients with nonalcoholic steatohepatitis. The control group consisted of 20 almost healthy humans, which consist the control group. The presence of hepatic steatosis was confirmed ultrasound, and testified in favor of the nonalcoholic steatohepatitis, in addition to the ultrasound changes, increased activity of serum transaminases – alanine aminotransferase, aspartate aminotransferase.
In the process of investigation detected significantly increase the level of homocysteine blood plasma in patients from both groups, compared to the control group. I group – 13,5±3,59 mmol /l, II group – 15,5±3,33 mmol/. In patients with nonalcoholic steatohepatitis average values hyperhomocysteinemia were higher than in patients with non-alcoholic steatosis. Total cholesterol and atherogenic index were increased in both groups of patients. Triacylglycerol level was increased only in patients with nonalcoholic steatohepatitis ( II group). The level of high-density lipoprotein in patients with nonalcoholic fatty liver disease both groups was significantly lower than in the control group, but the differences between the level of this index in the two groups have been found. Also had been detected positively correlation dependence of homocysteine levels with body mass index and dependence of homocysteinemias level of cholesterol in patients with steatohepatitis comparing to patients with steatosis. The levels of alkaline phosphatase and gamma-glutamine transferase compared with the control group did not change, but increases in patients with nonalcoholic steatohepatitis. Revealed the positive correlation between transaminase liver and plasma homocysteine in patients with nonalcoholic steatohepatitis.
In the study, we conclude that nonalcoholic fatty liver disease is accompanied by the development of hyperhomocysteinemia, which progresses with the development of nonalcoholic steatohepatitis. This allows us to treat hyperhomocysteinemia as a factor in progression disease of liver.
Key words: non-alcoholic fatty liver disease, hepatic steatosis, steatohepatitis, homocysteine.
Authors: Baiduja O. М.
Purpose: to determine the visco-elastic properties of blood vessels and endothelial function and their relationship in patients with essential hypertension (EH) of ІІ stage.
Materials and methods. The study enrolled 150 patients with average age 51,6 ± 10,9 years. The main group consisted of patients with EH of ІІ stage. The control group consisted of 30 healthy individuals of comparable age.
Discussion. It was determined that in patients with ІІ stage of EH there were significant changes in the visco-elastic properties of arterial vessels of musculo-elastic and muscular type. This was manifested in increased tone of large, medium and small arteries and reduced slow fast blood flow and in them. These changes prevailed in the shoulder and the internal carotid artery basin with advantage in the last one.
The direct dependence of these changes in the vessels from blood pressure level with advantage in the grade 3 of hypertension was revealed. Similar changes were observed in parameters of pulse wave velocity.
Using compressive brachial artery hyperaemia we determined that significant changes of endothelial function took place already in patients with the grade 1 of arterial hypertension. Such changes were depended from the degree of blood pressure elevation and have its maximum significant changes in subjects with grade 3 of arterial hypertension. Correlation between parameters of visco-elastic properties of arterial vessels and endothelial dysfunction confirms important pathogenic role of the last one in the development and progression of remodelling process and process of blood flow disturbances in vessels at the II stage of hypertension.
Keywords: visco-elastic properties of blood vessels, endothelial dysfunction, essential hypertension, arterial hypertension.
Authors: Fushtey I., Gura E.
Purpose: to determine the status of endothelial function and peculiarities of remodelling of the left ventricle (LV) in patients with essential hypertension (EH) in combination with diabetes mellitus type II (DM type II).
Materials and methods. The study involved 90 patients at a mean age 59,2 ± 8,6 years. In 60 patients we diagnosed EH in combination with diabetes mellitus type II.
Discussion. Using Doppler-cardiographs, biochemical and immune methods it was found that in patients with essential hypertension stage II in conjunction with type II diabetes mellitus there is significant endothelial dysfunction, manifested by an increase in the concentration of serum endothelin 1 on the background of lower metabolic products of nitric oxide and endothelium-dependent vasodilatation. Direct dependence of endothelial function from the type of left ventricular remodelling determined, and it is significantly more important in patients with eccentric hypertrophy and concentric remodelling. In patients with the combination of diabetes mellitus type II and EH stage II we determined systolic and diastolic LV dysfunction, which are determined by a decrease in ejection fraction, myocardial contraction of the circular on the background of high rates of myocardial mass and LV myocardial mass index with their prevalence of hypertrophic and restrictive type of diastolic dysfunction. These changes in intracardiac hemodynamics prevail with concentric remodelling of the left ventricle. Highly reliable pair correlations between the main parameters of intracardiac hemodynamics and endothelial dysfunction determine the value of the latter in myocardial remodelling in hypertensive patients and diabetes type II.
Key words: remodelling of the left ventricle myocardium, endothelial function, essential hypertension, diabetes mellitus type II.
Authors: Seman-Minko J. S., Buryak A. G.,Nechitailo D. Y.
The aim of the study was to assess the development of children and formative stage of sleep in children who are breastfed, and explore features of health and functional status of nursing mothers.
To achieve this goal were examined dyad-pair «Mother feeding baby first year of life». Study design was descriptive construction of longitudinal observation over 4-6 months. Inclusion criteria were feeding breast milk at the time of the first survey. Examined – 87 pairs. Age of children at time of first examination ranged from 1 to 12 months. Age calculated in each child in weeks by subtracting the birth date from the date of inspection and the average was 24.0±1.76 weeks.
Established that the physical development of the surveyed children had a tendency to advance from age norms and accompanied by a significant increase in weight gain during the first month of life indicators rough motility within the 90% range on a scale Denver test. Formation of monophasic sleep in most children occurred in the first three months. In 13.8% of the surveyed children in the age group of 6 month sleeping was steel polyphasic, which can lead to inhibition of psychomotor development (correlation between nocturnal sleep duration and age at which the child is alone (r =-0.76; p<0.05), walking (r=-0.91; p<0.05), the formation of motor speech (r =-0.40; p<0.05) and modulated babble (r=-0.72, p<0.05).
Thus, in modern principles of breastfeeding physical and psychomotor development of children tends to advance the age norm. Irrational daily routine, unhealthy diet and bad habits of mother – smoking and alcohol consumption negatively affect the duration of breastfeeding and the individual performance of children.
Key words: breastfeeding, physical and psychomotor development, sleep, functional status of nursing mothers.
Authors: Pochinok T. V., Veselova T. V.
In recent years, scientists from many countries pay special attention to the problem of increasing the frequency of cases of connective tissue dysplasia in children. Earlier studies suggest that adolescence children with connective tissue dysplasia had been observed decreasing of major bio-elements in plasma index that are involved in the metabolism of connective tissue. Moreover, the same category of patients has manifestations of autonomic dysfunction. The increase of pathological changes in the connective tissue and chronic deficiency leads to increasing bio-elements of clinical manifestations with age, including autonomic changes. Despite the increased interest of scientists to this problem, the development of methods for correction of electrolyte imbalance and autonomic disorders is relevant and unsolved.
To evaluate the effectiveness of the correction of electrolyte imbalance and autonomic disturbances in children with puberty manifestations of connective tissue dysplasia.
Materials and Methods.
We examined the effectiveness of the correction of electrolyte imbalance by determining the level of macro and microelements in blood plasma by atomic emission spectrometry with inductively coupled plasma, and autonomic disorders with Wayne’s tables, cardiointervalography, clinoorthostatic sample, and Roofie’s tests in 63 adolescence children (33 children with manifestations of connective tissue dysplasia and 30 children without dysplasia).
Children with connective tissue dysplasia used a 30-day rehabilitation complex, which included a rational mode of the day with a sufficient duration to age-appropriate night's sleep, morning gymnastics, daily rest, 2-hour dosage walking in the fresh air, the alternation of mental work with physical exercise, balanced by basic food ingredients with a daily consumption of foods with a high content of proteins, glycosaminoglycans, vitamin "C", «E», «A», the group «B», «PP», macro and microelements; body massage, as well as drugs: "Calcemin", and "Magne - B6". Also, the choice of drugs for the correction of electrolyte balance and autonomic dysfunction due to the presence of the bulk composition of macro and micronutrients are a part of enzymes metalloproteinase and provide structural integrity of connective tissue.
There were determined the level of basic bio-elements in plasma and performed functional tests for monitoring indicators vegetative maintenance before and after the rehabilitation course in children.
Also, we have observed significant changes of electrolyte balance indicators (decrease of magnesium, calcium, inorganic phosphorus, zinc, iron, copper, selenium) before the treatment of children with connective tissue dysplasia as compared with those of the children without dysplasia.
After the course in adolescence children with hereditary connective tissue dysplasia the level of frequency of asthenic complaints and vegetative character decreased, which leads to the restoration of autonomic dysfunction in this group of patients.
The tests showed normalization of electrolyte balance indicators as the principal bio-elements failure which gives the structure and metabolism of connective tissue.
Keywords: children, connective tissue dysplasia, electrolyte balance.
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Authors: Popov S. V., Bokova S. I., Smiyan A. I., Bugaenko V. A.
Introduction. Heart murmurs are diagnosed in pediatric patients often. The structural changes in the heart, which may be cause, in most cases fails to detect. Such murmurs are functional or innocent.The one of the factors which causes sound changes may be small anomalies of the heart. The aim was to study features heart structural and intracardiac hemodynamics.
Material and Methods. The 137 children with innocent heart murmurs in age from one year to 16 years were examined by echocardiography. Criteria for allocation in the groups were years old of children. Children aged from 1 to 3 years were included in the first group, from 4 to 7 years were included in the second group and from 7 to 14 years were included in the third group. We identified small malformations of the heart and made the analysis of indicators intracardiac hemodynamics.
Discussion. The innocent heart murmurs were detected in children of the first group - 23,36%, of the second group - 46,72% (p<0,05) and third group - 29,93% (p<0,05). The detection rate of small defects was high from 46% to 53%. Abnormally located chord and trabeculae were the most common. Changes in intracardiac hemodynamics in children up to 3 years were 71,88%, from 4 to 7 years - 82,81% and older than 7 years - 46,34%. The basic indicators of hemodynamics showed changes in systolic and diastolic function of myocardium.
Conclusion. Small heart malformations were detected in 50% of children. Abnormally located chord and trabeculae were the most common. The intracardiac hemodynamics changes were observed in most of the children. They showed an increase of left ventricular preload and right ventricle afterload.
Keywords: innocent murmurs, hemodynamics, small malformations of the heart.
Authors: Khyzhnjak M. V., Potapov A. A., Makeeva T. I. Bodnarchuk J. А.
The incidence of traumatic spinal injuries increased with the development of science and technology, including the spinal column. Only 10-25% of spinal injuries are complicated by spinal cord or its neural structures. There are stable and unstable injuries of the spinal column. Instable lesions there is no possibility of secondary traumatic vascular-neural structures of the spinal canal, with unstable fractures it is possible and that leads to surgical operations aimed at stabilizing the damaged segment. At this time in Ukraine puncture introduction of bone cement is included to the relevant clinical protocols for acute traumatic fractures and post-traumatic osteonecrosis of the vertebral bodies.
The purpose of the study was to examine long-term results of treatment the traumatic fractures of vertebral by рunctive percutaneous methods.
Long-term results of percutaneous vertebroplasty and kifoplasty in the surgical treatment of 65 patients aged 51 ± 1,6 with traumatic compression fractures of the vertebral bodies were analyzedand presented. We made 65 operations. All operations were carried out by transpedicular access under discrete intraoperative radiological control using electron-optical converter. The average duration of the operation on a single vertebra was 26 ± 0,4 minutes. The dynamics of the intensity of pain and restoration of life by Oswestry scale and assessment of posttraumatic deformity by measuring the Cobb angle were evaluated. The positive trend in a regression of pain, improved quality of life for patients. Increase the value of post-traumatic deformities in the postoperative period were revealed.
Based on the findings of long-term results of treatment patients with compression fractures of the vertebral bodies by these methods of surgical intervention we can report about their high efficiency, which reduces the degree of disability and significantly reduce post-operative rehabilitation.
Keywords: trauma, fracture, vertebra, percutaneous vertebroplasty, kifoplasty, posttraumatic deformity.
Authors: Fedorov S.V.
Introduction. Heart failure (HF) is the end stage of most diseases of the cardiovascular system and is a major cause of morbidity and mortality. About 26 million adults worldwide are living with HF, leading some to describe it as a global pandemic. This syndrome caused of 5% of acute hospital admissions, 10% of hospital bed occupancy, and accounts for approximately 2% of national expenditure on health, mostly due to the cost of hospital admissions. Across the globe, 17-45% of patients hospitalized with HF die within 1 year of admission and the majority die within 5 years of admission.
An inﬂammatory activation in CHF patients has long been recognized. Indeed, immune mechanisms modulate interstitial ﬁbrosis, cardiomyocyte apoptosis, and hypertrophy, all of which are central processes leading to maladaptive remodeling in response to a variety of stimuli (ischemia, glucose intolerance, obesity, pressure overload etc.). Especially for heart failure evolving from large myocardial infarction there is substantial evidence for a causal contribution of immunity early in the course of the disease.
Pharmacological therapy of HF including administration of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor II blocker (ARB), beta-blocker (BB), and aldosterone receptor antagonist (AA) can reduce morbidity and mortality in patients with HF. Ivabradine is a new therapeutic agent designed to reduce heart rate at rest and during exercise by selective inhibition of a novel receptor (If channel) located on the pacemaker-cell membrane within the sinoatrial node. As such, ivabradine joins a list of rate-limiting medications already available to prescribers for the control of heart rate in coronary artery disease (CAD) and HF with systolic dysfunction. The ω-3 polyunsaturated fatty acids (ω-3 PUFA), such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are known as anti-inflammatory factors, and are using for HF treatment.
The aim of study was to investigate the possible influence of ivabradine and ω-3 polyunsaturated fatty acids for immunity values in patients with ischemic heart failure.
Material and Methods. 357 patients with ischemic HF and sinus rhythm were observed. In accordance to treatment all patients were divided into four groups: I group – basic treatment (89 patients); II group - basic treatment and Ivabradine (Coraxan, Les Laboratoires Servier Іndustrie, France) – 5 or 7,5 mg twice a day (depends of heart rate); III group - basic treatment and PUFA (Omacor, Abbott Laboratories GmbH, USA-Germany) – 1000 mg per day; IV group – basic treatment with Ivabradibe and PUFA in similar doses. All patients were examined before and after 6 months of treatment. Control group – 30 practically healthy persons. The study was performed in accordance with the Helsinki Declaration and Good Clinical Practice Guideline. The study was approved by the local ethics committee and written informed consent was obtained from all patients.
We investigated of lymphocyte’s populations count by indirect immunofluorescence method and immunoglobulin’s level by ELISA. All analyses were undertaken using the Statistica 12.0 (StatSoft, Tulsa, OK, USA). Statistical significance was assumed at p<0.05.
Results and Discussion. The average age of observed patients with HF was (67,98±12,06) years. Among all patients 278 persons (77.82 %) were males. HF FC ІІ (NYHA) was verified in 63 patients (17.65 %); ІІІ – in 238 (66.67 %); IV – in 56 (15.68 %). The averageduration of HF was (10.0 [5.0; 15.0]) years.
No influences for CD3+, CD4+, CD8+, CD16+ cells count were observed in all groups. Usage of ω-3 PUFA caused of stronger decline of CD19+, CD25+ and CD95+ lymphocytes levels for 9.5%, 16.5% and 50.9% respectively (p<0,05).
Conclusion. Thus, omega-3 polyunsaturated fatty acids have immunomodulative effect for normalization of of CD19+, CD25+ and CD95+ lymphocytes.
Key words: placenta, fetus, full-term newborn.
Authors: Skiba T.A.
Introduction. The possibility of using pentoxifylline and L-arginine additionally to basic treatment of exacerbation of chronic obstructive pulmonary disease, concomitant with osteoarthrosis was considered in the article. Purpose. The aim of this investigation was to study the effectiveness of combination pentoxifylline and L-arginine on general pathogenetic mechanisms of chronic obstructive pulmonary disease concomitant with osteoarthritis, particularly on systemic inflammation, estimated on the level of leukotriene B4 (LTВ4) at the patient’s serum.
Matherials and methods. Was observed 33 patients in age (54,4±3,1) years old. All patients were smokers. As a marker of chronic systemic inflammation was used a level of leukotriene (LT)B4 at the serum. Results. Initial level of LTВ4 of observed patients was 14,6-fold more from normal (P<0,001) and achieved (8748,4±462,37) pg/ml. All patients were divided on two representative subgroups A and B. Subgroup A used only basic treatment according to protocol. To patients of subgroup B were added pentoxifylline and L-arginine. As a result, among the patients of subgroup B was achieved more significant positive clinical results and decreasing of serum LTВ4 concentration. Strong negative correlation between the FEV1 and the level of LTВ4 at all patients before the treatment was changed on moderate negative at the patients subgroup A and on wick negative at the patients of subgroup B.
Key words: chronic obstructive pulmonary disease, octeoarthrosis, treatment.
Authors: Potapov O. O., Kmyta O. P.
Secondary changes in the brain that occur during the early posttraumatic period remain a major cause of death in patients with severe traumatic brain injury. The purpose of our study was to analyze brain changes over time in patients with severe traumatic brain injury by means of studying the association between the results of computed tomography examinations and the -675 4G/5G polymorphism in the PAI-1 gene with the prediction of the secondary thrombohemorrhagic complications.
119 patients with severe traumatic brain injury have been examined. Computed tomography changes of brain tissues in patients with severe traumatic brain injury have been investigated. Determination of the -675 4G/5G polymorphism in the PAI-1 gene performed. Statistically results processing have been done with using of programs SPSS-17.
We have found an association between posttraumatic computed tomography changes of brain tissues in patients with severe traumatic brain injury and the genotypes for the -675 4G/5G polymorphism in the PAI-1 gene, namely more pronounced and accelerated involution of lesions in patients with 5G/5G genotype; more rapid recovery in patients with 4G/4G genotype; confirmed predisposition to developing secondary complications, pathological lesions evolution in the brain, and secondary ischemic complications in patients with 4G/5G genotype for the investigated polymorphism.
Obtained results proved the availability of connection between genotypes -675 4G/5G polymorphism in the PAI-1 gene, secondary complications, pathological lesions evolution in the brain, and secondary ischemic complications in patient with severe traumatic brain injury.
Key words: severe traumatic brain injury, computed tomography of the brain, prediction of the secondary thrombohemorrhagic complications, the -675 4G/5G polymorphism in the PAI-1 gene.
Authors: Pruystupa L. N., Bondarkova A. M., Guyva T. O.
According to the data of international authors it was proven, that there existed direct connection between severity level of bronchial asthma (BA) and polymorphism Gln27Glu gene β2-adrenoceptor (ADRB2), but in Ukrainian population this connection wasn’t investigated. Therefore, the purpose of our investigation was to study severity level of BA in dependence of Gln27Glu polymorphism ADRB2 gene in Ukrainian population.
Materials and methods. 186 patients with easy, average and severity persistent BA in ages from 18 toll 70 had been investigated. The diagnosis had been determined on the base of GINA (2011) recommendations and Decree of Ukrainian Ministry of Public Health №128 19.03.2007. The control group involved 87 almost healthy humans without allergopatology and unencumbered with allergic history. Determination of the allelic polymorphism of 1st exon ADRB2 Gln27Glu (rs1042714) had been performed by polymerase chain reaction method with following analyze of the lengths of restrictions fragments. The statistic processing of results had been done with help of SPSS-17.
Results of investigation. Depends on severity level of BA patients which had been divided into3 groups. 1st group involved 103 patients with easy course, 2 group – 52 with average severity course, and 3 group – 31 with severe course. After conducting investigation in first group results were such frequency of genotypes ADRB2: Gln27Gln – 80,6%; Gln27Glu – 15,6%; Glu27Glu – 3,8% respectively, in second group: 7,7%; 90,4%; 1,9% respectively, and in third group – 27,9%; 4,4%; 67,7% respectively.
Obtained results showed that genotype Gln27Gln likely more often met in patients with easy course of BA, genotype Gln27Glu – in patients with average severity course, and genotype Glu27Glu more likely detected in patients with severe course (p=0,02; p<0,05 by χ2 – Pirson’s criteria). Using genotype Gln27Gln as reference had been determined that existence of homozygotes by minor allele Glu27Glu genotype in patients regardless of the sex increased the risk of BA occurrence with severe course twice.
Thereby, there is a connection between polymorphism Gln27Glu ADRB2 gene and the severity of bronchial asthma course.
Key words: β2-adrenoceptor, Gln27Glu allelic polymorphism, bronchial asthma, asthma severity
Authors: Khyzhnjak M. V., Potapov A. A., Tanasiichuk A. F., Novakovic E. S., Priymak E. V.
Every year in the United States carried out more than 200 thousand primary microdiscectomy, the frequency of repeated interventions of up to 22% [1,2], and the relapses of hernias of intervertebral discs(ID) are between 3-15% . However, despite the good results microdiscectomy, the problem of recurrence of pain syndromes are still relevant. Recurrences of pain syndromes can be caused by the formation of a hernia operated or adjacent vertebral-motor segment, segmental instability, various forms of degenerative spinal canal stenosis, epidural fibrosis [3, 4, 5]. Medical and social problems relapses of hernias of intervertebral discs caused by a decrease in the quality of life of the working population, significant economic losses and disability of patients. In Ukraine, the proportion of patients with spinal osteochondrosis of the working population in the structure of diseases of the musculoskeletal system reaches 40%.
The purpose of the study was to examine nearest, intermediate and long-term results of surgical re-treatment in patients with discogenic syndrome of lumbar spine, on the basis of differentiated application of surgical techniques.
A dynamic observation of 364 patients who were re-operated on in the department of minimally invasive spinal neurosurgery and laser State Institute of Neurosurgery. Acad. AP Romodanov Kyiv in the period from 2003 to 2012 for recurrent discogenic pain syndromes. Patients were divided into five main groups. 1) I ─ 196 patients who were operated on for ipsilateral (true relapse) hernia ID. 2) IІ ─ 22 patients who underwent microdiscectomy ID, followed by the installation of systems transpedicular fixation. 3) IIІ─ 11 patients who underwent removal of recurrent hernia ID, and the installation of a dynamic system such as fixing DIAM or COFLEX. 4) IV ─ 46 patients who underwent microsurgical removal of contralateral hernia previously operated ID. 5) V ─ 89 patients who underwent microdiscectomy on an adjacent level ID. Estimation of efficiency of surgical treatment of re-operated patients with herniated discs of the lumbar spine was performed in early (1months), intermediate (6 months) and long-term (12 months) the period of observation.
Results of surgical treatment were also evaluated on the basis of the relationship structures in the operated using PDS roentgenometer. Postoperative studies conducted during the second and third groups of observations indicated restore biomechanical relationships PDS, which was a proof of the correctness of the operation. The results of radiometric studies in patients of group III were carried out at different times after surgery.
Key words: osteochondrosis, discogenic pain syndrome, re microdiscectomy , Oswestry index , the index of the Roland -Morris.