Vol 3, No 4 (2003)

Modified low density lipoproteins and obligate parasites, playing very important role in the development of immune inflammation under atherogenesis, activate apoptosis of arterial cells intima during the most initial stages of the development of atherosclerotic damages of blood vessels. Apoptosis of arterial cell walls fulfills both negative role, producing cell death and promoting thromboses formation, and positive role as an integral protective-adjustment process, activating phagocytes and controlling cell proliferation. Peroxidemodified low density lipoproteins (mLDL), especially including into an immune complex one, not are cytotoxic for macrophages, but at the same time are the main cause of their apoptosis. Apoptosis of macrophages, smooth muscle cells and endotheliocytes under atherogenesis can be induced both mLDL, and cell reactions, going with the development of immune inflammation into the zone of atherosclerotic damages of arteries.

Hyperhomocysteinemia (HHcy) is an established risk factor for both arterial and venous thrombosis, arising from the interaction of genetic and environmental factors. Concerning Russia there are very limited data on this problem. We studied 84 unrelated patients with documented thrombotic diseases and 30 age and sex matched controls in order to evaluate the significance of HHcy and MTHFR genotype in arterial and venous thrombosis in the population of North Western Russia. We showed HHcy significantly more prevalent in patients than controls. A significant association between HHcy and recurrent thrombosis was also observed. Hcy levels were raised in cigarette smoking patients with a high caffeine intake, an effect further pronounced in subjects with coexistent C677T substitution. After supplementation by folic acid Hcy levels significantly reduced in all patients. Our study demonstrates HHcy to be a frequent and independent risk factor for thrombotic complications and their recurrences in the population of North Western Russia. We recommend that patients with idiopathic and particularly recurrent thrombosis would benefit from tHcy determinations in diagnostic thrombophilia screening strategies. Additionally, we consider that routine MTHFR polymorphism screening offers a good opportunity to identify individuals at increased risk of developing HHcy. Importantly HHcy is easily reversible in the majority of cases by improved patient awareness and vitamin supplementation.

The article presents a review of modern modalities being used at the CRIRR for diagnosis and treatment for pancreatic cancer.

For diagnosis of neoplasms of the pancreas, besides standard examinations (US, CT, MRI, angiography), new modalities are widely used: spiral CT, specific techniques of MRI, positron emission tomography, US- guided transcutaneous needle biopsy. These methods enable not only to make diagnosis, indicate a type of tumor, determine its extent and choose the optimum method of intervention but also to assess adequatly treatment results and make corrections in treatment tactics.

For treatment, a principally new method of regional chemotherapy, oily arterial chemoembolization, is used. This technique has allowed to increase the survival in patients with locally-spread unresectable cancer of the pancreas that is similar to radical surgical treatment for earlier stages of the disease.

Chemoembolization is a well-tolerated procedure and can potentially be used as neoadjuvant chemotherapy in operable patients.

An antiviral property of a low molecular interferon inducer - amixin has been analyzed on in vitro models of influenza virus infection in tissue culture. As a result of our investigations it was revealed that amixin has a direct effect on RNA virus reproduction (e. g., influenza viruses) and inhibits a synthesis of viral nucleic acids. Moreover, amixin is equally active as for rimantadine-resistant influenza viruses type A, so as for influenza viruses type B, that is characterized by naturally occurring amantadine and rimantadine resistance. Amixin belongs to the preparations that succesfully combine interferon-inducing activity and direct antiviral effect, that could be considered as an advantage comparing with cycloferon and neovir. However, amixin demonstrates high cytotoxicity thus calling for improvement of its therapeutic efficacy. New antiviral derivatives of fluorenone and improvement of amixin biological characteristics development can be reached by introduction of specific substitutions into symmetrical aminoethoxigroups.

In this article we have analyzed the use of different small-invasive technologies in treatment of 4889 patients during the period of 1983 through 2003. Ultrasonography was used during the punction and punction-draining invasions in 640 patients with cysts of different localizations: intra and extraorgan abscesses, acute pancreatitis, gall bladder diseases and gall ducts and also haematomas. Endoscopic flexible fiber technology was used for polypectomies of different localizations in 571 patients, for gastrointestinal bleedings in 780 patients and also for 1389 cases of ERCP and 445 EPS, the last procedure in 112 cases was combined with a mechanical litotrypsy (ML). Endovideosurgical method was used in treatment of 128 patients with cholecystitis, 21 with tumors of adrenal glands, 84 with perforative gastroduodenal ulcers, 32 with acute pancreatitis.

The present-day stage of public health development is characterized by search for new approaches to organization of secondary (medical) prophylaxis and early diagnostics of socially significant noninfectious diseases. The article presents the results of special purpose (screening) examination of population aimed at detection of cancer diseases and formation of risk groups. From 24 to 32% of the respondents participating in questionnaire were subject to thorough medical inspection. The percentage of examined people with revealed cancer diseases in different administrative territories varies from 0,5 to 2%. Average expanses for medical examination of one person amount to 1100 roubles. Thus, expanses for treatment of one patient having a serious form of malignant tumors is 6-8 times higher than costs for early detection of the disease, and 15-20 times higher than costs for detection of precancer diseases. The results of the examinations give evidence of high medical and economic efficiency of screening medical inspection of population aimed at early detection of malignant tumors.

Three dental pastes containing biologically active agents on the base of laminaria and chlorophyll derivatives were studied in the experimental model of inflammatory degenerative lesions of parodont tissue in Wistar rats. The pathological process was modeled by means of 2% formaldehyde solution that was injected into parodont tissue of rats in volume 0,15 ml. Both malonic dialdehyde and dienic conjugates were twice increased in serum and parodont tissue, while recovered glutation and superoxide dismutase activity were significantly decreased. The dental pastes «lesmin-dent» > «klamin-dent» > «zhemchug» (in reducing order) abolished or decreased the pathological signs due to inflammation and degeneration of parodont tissue, assessed with lipid peroxydation and antioxydative processes. Thus, dental pastes with laminaria and chlorophyll derivatives are effective as preventive and curative agents in experimental parodontitis.

Main peculiarities of intracardiac infection are analyzed from the infectology standpoint. Specificity of etiology, pathogenesis, clinical picture and diagnostics of this pathology determines distinctive requirements imposed upon the treatment of patients with intracardiac infection. Determination of pyo-septic cardiosurgery as an independent branch of clinical medicine has become possible only on a basis of profound integration of both clinical and theoretical achievements. Early diagnosis, active surgical tactics, rehabilitation system and dispensary observation can provide a significant improvement in treatment of patients with intracardiac infection.

Taking into account the in vitro and in vivo experimental results presented, the original technology of inner surface PTFE vascular grafts lining with endothelial cells has been developed. The new technology consists of the following stages: primary endothelial cell culture isolation, stimulation of endothelial cells proliferation, PTFE vascular grafts inner surface pretreatment including stable positive surface potential creation, endothelial cell seeding. The experimental results showed high performance of the new vascular grafts.