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"vestnik vsmu" 2011  vol. 10 №2

Review

Kulikov V.A.
Proteome of high-density lipoproteins

Abstract. In this literature review the results of recent scientific researches of proteome of high-density lipoproteins by means of mass spectrometry methods of analysis are summarized. More than hundred proteins have been found in the composition of these lipoproteins. However, the presence of only fifty one of them has been confirmed by two or more researches. The value of these researches for understanding the molecular bases of high-density lipoproteins function is discussed.

Biochemistry

Grebennikov I.N., Kulikov V.A.
High-density lipoproteins: not only reverse transport of cholesterol

Abstract. Low level of high-density lipoproteins is regarded as a risk factor of atherosclerosis development. Except transfer of excesses of cholesterol from peripheral cells to the liver high-density lipoproteins also possess a number of other atheroprotective properties – antioxidant, anti-inflammatory, antithrombotic, antiapoptotic. Moreover high-density lipoproteins are a part of innate immunity system. Some of these properties, at least partly, are caused by proteins associated with high-density lipoproteins, such as paraoxonase and platelet-activating factor acetylhydrolase. However high-density lipoproteins can become dysfunctional and proatherogenic under certain conditions.

Khodos O.A., Gidranovich L.G., Sachek M.M.
The activity of proteinases and their endogenous inhibitors in brain tissue extract and in blood serum of rats in acute alcohol intoxication

Abstract. This study was undertaken to determine the activity of trypsinlike and cysteine proteinases and their endogenous inhibitors in brain tissue extract and in blood serum of rats in acute alcohol intoxication. It was determined that the activity of trypsinlike and cysteine proteinases and their endogenous inhibitors in brain tissue of rats in acute alcohol intoxication was not changed. The results of our study indicated no changes of proteinase activity and activity of i1-proteinase inhibitor and -2-macroglobulin in blood serum. The activity of endogenous inhibitors of cysteine proteinases in blood serum was increased by 87% in 90 minutes after ethanol injection.

Histology, cytology, embryology

Sobolevskaya I.S., Grushin V.N., Myadelets O.D., Kichigina T.N.
Sebaceous glands as lipid-containing and lipid-synthesizing structures of the human skin

Abstract. Sebaceous glands are the most important lipid-containing and lipid-synthesizing components of the human integumentary system. They play an important role in the processes of synthesis, accumulation and emission of fat. Many physiological properties of the human integumentary system depend on the normal releasing activity of sebaceous glands. The glands play a great role in the processes of skin aging.
In this article the results of the researches dedicated to microstructure, histological features of sebaceous glands, their connection with the hair follicles and other structures of the human skin are presented. The article contains their localization data, essential differences in sebaceous glands structure of various regions of the human integument are shown in it.

Microbiology

Studenichnik T.S., Shevlyakov V.V., Filonyuk V.A., Ehrm G.I., Shchurskaya N.A., Buynitskaya A.V., Chernyshova E.V., Коzlovskaya Т.V.
Scientific substantiation of the requirements aimed at safe production and application of IM-B1, IM-MK1 preparations on the basis of bifid- and lactic acid bacteria in cosmetology

Abstract. Microbial preparations on the basis of bifid- and lactic acid bacteria do not possess any significant acute toxicity, but show marked allergenic, antigenic and hemotoxic properties in the experiments.

Pathologic anatomy

Bekhtereva I.A., Gustovarova Т.А., Shcherbakova L.A., Panteleyeva T.L., Sidorov I.V.
The peculiarities of expression of steroid hormones, proliferative activity, area of vascular bed in the tissues of the uterus in submucous myomas and glandular endometrial hyperplasias

Abstract. Basing on the results of the investigations it was concluded that receptor hormonal status of the uterus tissues depended on the type of pathology (submucous myoma of the uterus, glandular endometrial hyperplasia or their combination). The determined changes in the system of microcirculatory bed and namely the decrease of the area of the vascular bed influence the sensitivity of myoma of the uterus to exogenous hormones. It is necessary to study hormonal status and the area of microcirculatory bed when combined pathology of the uterus is revealed. This fact should be considered while choosing the surgical treatment with preservation of the reproductive organs.

Cardiology

Prokoshina N.R.
Prognosing of relative risk of total mortality in persons with arterial hypertension (according to the data of ten-year cohort study)

Abstract. A multifactor model of reliably significant risk factors of total mortality was designed on the basis of the data of the ten-year period cohort study of persons with arterial hypertension (1999-2009). It includes high index of body mass, marked hypertrophy of the left ventricle according to ECG signs, non-optimal glucose level, myocardial infarction in the case history, alcohol abuse, high level of cholesterol of low-density lipoproteins, diabetes mellitus, high creatinine level, moderate hypertrophy of the left ventricle according to ECG signs, absence of higher education, high level of systolic arterial blood pressure, stroke in the case history, high heart rate, hypertrophy of the left ventricle according to echocardiographic signs, smoking involvement. The proposed multifactor model permits to single out groups of non-significant, low, moderately increased, high and very high risk of total mortality.

Internal medicine

Volkova M.V., Velichinskaya O.G.
Description of IgG abzyme activity in patients with early rheumatoid arthritis

Abstract. The study of abzyme IgG activity in patients with early rheumatoid arthritis in comparison with healthy persons was conducted. The clinical and pathogenetic significance of abzyme activity was assessed on the basis of correlation analysis between its levels, clinical signs and laboratory findings.
The levels of DNAse and superoxide dismutase IgG activity in the examined patients were higher in comparison with those in the control group. There were no differences between the levels of BAPNA-amidase and catalase activities in patients with arthritis and healthy persons. We revealed statistically significant (p<0,05) relationships between DNAse IgG activity and the number of tender joints (r=0,42), the level of C-reactive protein (r=0,59), the number of CD4+ Т-lymphocytes (r=0,76), phagocytic index (r=0,85), between catalase activity and the duration of the disease (r=-0,46), the number of CD8+ Т-lymphocytes (r=-0,82), that confirms the clinical and pathogenetic significance of abzyme IgG activity in early rheumatoid arthritis and points to the participation of abzymes in the development of autoimmune inflammation in this disease.

Pediatrics

Matyushchenko O.V.
The levels of IgA, IgM, IgG in children with allergic bronchial asthma and atopic dermatitis

Abstract. This article presents the results of clinical and immunological survey of 68 children with allergic bronchial asthma and 22 children with atopic dermatitis.
Considering the number of acute respiratory infections in anamnesis we have revealed reliable differences in these groups of patients (p=0,017). Concentrations of IgA, IgM, IgG in blood serum of the examined patients were determined by means of enzyme-linked immunosorbent assay (ELISA). We have found out that 33.8% of children with asthma and 36.4% of children with atopic dermatitis have reduced levels of IgA. Also we have determined low concentrations of IgG in more than half of the examined patients both in the group with asthma and in the group with atopic dermatitis (58,8% and 59,1%, respectively), that in combination with low levels of other immunoglobulins can be regarded as transient immunodeficiency in children.

Surgery

Lyzikov A.A., Osipov V.A.
The range of microorganisms in case of pyo-trophic lesions in patients with vascular pathology

Abstract. The aim of the study was to determine the groups of antimicrobial agents for empirical antibiotic therapy on the basis of the results analysis of microbiological investigations of wound contents of trophic ulcers.
The results of 126 bacteriological investigations conducted at Gomel regional vascular surgery department from 2006 to 2007 were analyzed.
The most frequent contamination of trophic ulcers was caused by Staphylococcus aureus (47%) and Pseudomonas aerugenosa (13,7%) or by their associations with the representatives of normal flora. Some patients were contaminated only by enterobacteria (Enterobacter cloacae, Enterobacter agglomerans) and even Streptococcus viridians.
Thus the use of fluorquinolones (ciprofloxacin - 59,8% of sensitive strains), carbopenemes (imipenem - 52,1% of sensitive strains) or aminoglycosides (gentamycin - 45,3% of sensitive strains) for empirical therapy until antibioticogram is obtained proves to be correct.

Bogdanovich A.V., Shilenok V.N., Kirpichenok L.N.
Enteral detoxication in early postoperative period in patients with acute adhesive intestinal obstruction

Abstract. The results of surgical treatment of 60 patients with acute adhesive intestinal obstruction are presented. The patients were divided into two groups according to the method of performing intestinal lavage. In the first group intestinal lavage was made with the application of physiological salt solution. In the second group intestinal lavage was performed with the application of the proteolysis inhibitor – ovomine. Ovomine dose was calculated in the experiment in vitro. In this group of patients a more rapid decrease in the proteolysis activity of the small intestinal contents and of general proteolytic activity of blood serum, as well as endotoxicosis severity reduction (estimated according to SAPS scale) were observed, that contributed to the sooner improvement of their general condition, appearance of intestinal peristalsis, and elimination of enteral insufficiency.

Denisenko V.L., Gain Y.M.
Experimental estimation of the role of bacterial intestinal translocation in the pathogenesis of obturative large intestinal obstruction

Abstract. The experiments which included the modeling of low large intestinal obstruction by means of blocking straight intestinal lumen in its distal part with the help of the compressing device applied extrasphinterally with the subsequent study of the regularites of contamination of the abdominal cavity, portal and caval venous systems depending on the duration and stage of the disease have been conducted. It has been determined that in case of modeling of acute large intestinal obstruction severe peritonitis and sepsis develop in all experimental animals. The fact of pathogenic microflora translocation from the distal part of the digestive tract into its proximal ones and from the intestinal lumen into the abdominal cavity as well as the system of the portal vein and vena cava, playing an important role in the development of peritonitis and abdominal sepsis has been confirmed. The determined regularities enable us to establish the main directions of complex treatment of complicated obturative large intestinal obstruction from the stand of the pathogenesis of the disease.

Infectious and parasitic diseases

Khnykov A.M., Skvortsova V.V., Semenov V.M.
Clinical features of adenovirus infection in children

Abstract. The aim of this research was to determine clinical features of adenovirus infection course in children with the confirmed diagnosis. The diagnosis was confirmed by the method of fluorescing antibodies and PCR-method. The result was the prevalence of the triad of signs: pharyngitis, rhinitis, regional lymphadenopathy. Habitual for adenovirus infection tonsillitis symptoms, conjunctivitis, hepatomegaly were registered rather rarely - in 16,35-28,85% of cases. The most frequent complications of adenovirus infection are obstructive bronchitis which occurs as a rule in children under one year of age; laryngotracheitis, which occurs in children from one year to seven years; pneumonia, developing mainly in children over one year of age.

Pashinskaya E.S., Bekish V.Ya.
Genotoxic, cytotoxic and embryotoxic effects of trichinellosis in combined treatment of host invasion in pregnancy

Abstract. The aim of the study was to develop an effective way of genome protection of the host and its embryos on application of specific, pathogenetic and antioxidant therapy of experimental trichinellosis in pregnancy of rats. It has been established that the use of albendazole or mebendazole for trichinellosis therapy in pregnant females of rats does not reduce genotoxic and cytotoxic effects in the cells of bone marrow and their embryos. 55-63 times increase of the main index of genotoxicity («tail moment»), 10,3-10,6 times increase in the percentage of apoptotic cells in comparison with the intact control are observed. Therapy with albendazole or mebendazole in combination with ibuprofen, phencarole and vitamin complex with selenium reduces genotoxic and cytotoxic effects of invasion in somatic and embryonic cells of the host up to control indices and is an effective way of genome protection of animals.
Injection of one of helminthicides to noninvaded females of rats from the 16th to the 18th days of pregnancy does not lead to the increase of embryotoxicity indices. Preimplantation death and postimplantation mortality do not exceed the control level. In treatment of experimental trichinellosis with albendazole or mebendazole the reliable increase in preimplantation death up to 21,9% - 33,3% and postimplantation death of embryos up to 26,9%-50,1% in comparison with the groups of intact control and «pure invasion» is observed. The application of one of helminthicides (albendazole or mebendazole) in combination with ibuprofen, phencarole and vitamin complex of antioxidant character has not shown any reliable differences of the levels of preimplantation and postimplantation death from the data of the intact control.

Allergology and immunology

Semyonova I.V., Vykhristenko L.R.
The structure of pollinosis morbidity in Vitebsk region

Abstract. The article presents the structure of pollinosis incidence, peculiarities of its course in the adult population of Vitebsk region. The influence of genetic factor and disease duration on the development and course of this disease has been evaluated. On the basis of anamnestic and laboratory data the frequency and spectrum of concomitant allergy have been revealed. The causatively significant allergens in the sensitization of patients with pollinosis have also been determined.

Endocrinology

Rusalenko M.G., Mokhort T.V., Sharshakova T.M.
Type 1 diabetes mellitus: compensation state and elaboration of organizational technologies of instruction and monitoring

Abstract. The program of medical-psychological correction was scientifically validated and elaborated for patients with type 1 diabetes mellitus (T1DM) of different age groups depending on compensation level and the indices of life quality. The organizational model of T1DM maintenance based on the work of multidisciplinary team and differentiated approach enabling the enhancement of treatment effectiveness was suggested and introduced into the medical aid structure.

Neurology and neurosurgery

Sidorovich R.R., Smeyanovich A.F., Guzov S.A., Yudina O.A.
Anatomical features of brachial plexus in view of surgical treatment of its structures

Abstract. The anatomical topography studies of brachial plexus conducted by the authors have confirmed the variability of its structure, the presence of anastomoses at the spinal nerve level, primary and secondary trunks, long nerve proximal sections. Anatomical orienting points of brachial plexus structures at supraclavicular and subclavicular levels were established; increased risk intraoperative damage areas of its structures and adjoining great vessels were determined. The internal structure of brachial plexus trunks at different levels was explored in detail.

Forensic medicine

Denisenko A.G.
Changes in immune indices of blood and concentration of nitrates/nitrites in plasma depending on the remoteness of death

Abstract. To establish the remoteness of death changes of leukocytes functional activity (the spontaneous and induced NST-test), phagocytic number, phagocytic index, the amount of T- and В-lymphocytes were analyzed in dynamics by the method of rosetting with erythrocytic CD3, CD4, CD8, CD25, CD22 diagnosticum sets, and NO degradation products concentration in plasma was determined, as well.
Disturbances of cellular and humoral immunity were revealed which were confirmed by statistically significant reduction of the induced NST-test and elevation of the spontaneous NST-test, phagocytosis characteristics, changes in the amount of T- and В-lymphocytes expressing molecules-markers CD3, CD4, CD8, CD25, CD22.
Dramatic elevation of NO degradation products concentration in plasma was observed in 2–6 hours time interval. Further the decrease of NO degradation products concentration was recorded in 7–16 hours time interval in case of deaths due to CHD and in the time interval 12–21 hours in case of deaths due to mechanical traumas.
The detected changes of immune indices and NO degradation products concentration in plasma may be used to establish the remoteness of death in medicolegal practice.

Stomatology

Chernyavsky Y.P., Kalenkovets Y.A.
Dynamics of the main medicostatistical indices of the oral cavity oncologic disease incidence in the population of Vitebsk region

Abstract. In this article the results of the analysis of the Belarusian republican cancer register data and those of the retrospective analysis of case histories of patients suffering from oncologic diseases in Vitebsk region are presented, morbidity, mortality, distribution according to diagnoses, disease outcome, the causes of neglect of lip and mouth cancer in residents of Vitebsk region over the period from 2005 to 2009 are studed. It was found that from 2005 to 2009 the incidence of malignant neoplasms of the oral cavity declined 2,7 times, disease incidence in men being 4 times higher than that in women. Among the tumors cancer of the lip was the most wide-spread - 38%, the first stage of it occurred in 34,2% of cases. Mortality from oral cancer was 1.4 per 100000, the five-year survival rate made up 45%. We detected 37% of patients with advanced disease and the causes of neglect were tardy patient treatment in 60% and errors in clinical diagnosis in 22% of cases.

Case from practice

Sapko G.F., Shturich I.P., Ryashchikov A.A.
The first experience of using laparoscopic resection of small intestine Instructions for authors

Abstract. In this article the case of treating the patient with small intestine tumour complicated by bleeding is described. The difficulty of diagnosing the given disease is shown, tactics and treatment method (laparoscopic resection of small intestine site with tumour) are determined.

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