Vol 2, No 1 (2011)

Cystic kidney dysplasia (CKD) in infants is a rare congenital pathology, associated with connective tissue dysplasia. Three autopsy cases of CKD reveals disturbance proportions of connective, fat, chondroid tissue with dominance cells and fibers of connective tissue. Kidney cysts formation with CKD, under our opinion, is secondary process due to compression few kidney tubules by undeveloped mesenchymal tissue.

Authors described a case of postoperative complications after total hip replacement. Joint replacement and reconstruction of the defect at the bottom of the acetabulum allowed to recover the architecture of the joint.

The use of prostatespecific antigen screening made it possible to detect an earlystage prostate cancer in young men in which nervesparing radical prostatectomy with preservation of erectile function could be performed. Laparoscopic radical prostatectomy (LRPE) is preferred as a nervesparing technique in the treatment of prostate cancer. During the last 2 years 19 patients underwent the modified Brussels technique transperitoneal LRPE, (extrafascial prostatectomy – 17, interfascial – 2). The average period of observation was 10.3 months. 13 of 14 patients were observated more than 6 months. In this group all patients achieved a complete continence, one of the patients remained urine leak with no more than 1 strip a day. Brussels technique provides better control of neurovascular fibers in the seminal vesicles during radical prostatectomy. Posterior approach to the prostate gland should be avoided in the nervesparing LRPE.

From 2008 to July 2010 95 patients underwent radical prostatectomy (RP) – 12 of them – laparoscopic prostatectomy, 83 – retropubic prostatectomy. In 43 patients suspension of urethral anastomosis was not performed. 11 patients underwent the Noguchi's front suspension (11,6%), 22 patients – Tewari's complete reconstruction of the fascial structures (23,1%) and 19 – complete reconstruction of the fascial structures with a modified technique of the rear suspension with a deficit of length of aponeurosis Denonvile (20%). Monitoring of continence was conducted on the third day of the removal of the catheter, in 1 month, 3 months, 6 months and 1 year. 74.7% of patients evaluated in a period of 6 months and only 54,7% of patients – in a year after surgery. On third day of removal of the catheter continence in a group without complete suspension was 20,9%, with front suspension – 27,3% in the group with Tewari's reconstruction – 49,9%, with Denonvile suspension – 36,8% respectively. 1month continence was 36,6%, 54,5%, 76,2% 78,9% respectively. Through threemonth observation full time continence was achieved in 63,8%, 60%, 85,7% and 73,3% respectively. Through 6 months and 12 months observation there was no significant difference in continence in all groups.

The purpose of the research was to develop a prescribing of immunomodulators Imudon, Viferon, Superlymph in the complex treatment of frequently ill children (FIC) with a frequency of ARI 6 or more times a year, foci of chronic infection in oro and nasopharynx, and intermittent (seasonal) AR mild or moderate severity (SAR). Methods: 120 FIC from 5 to 7 years old (56 boys and 64 girls) were followedup during 2 years. Investigation revealed pollen and household allergens predomination in the spectrum of causesignificant allergens. Microbial landscape of chronic infection foci in the oro and nasopharynx was characterized by a predominance of Staphylococcus aureus in 71,2%, Candida albicans in 28,8%, Streptococcus haemolyticus in 50% of patients. In 67.4% of patients microbial associations of 2 and 3 pathogens predominated. Immune system abnormalities were characterized by reduction in T cells, the level of serum IgA in 62.5%, gammaIFN – in 80%, alphainterferon – a 60% increase in serum IgG – at 62,5%, TNFα – 80,0%, and IgE – in 100% of the children. Supplementation of Imudon, Superlymph and Viferon as a component of complex treatment of this category of children reduces the mucous contamination with active forms of Candida albicans by 24 times, with bacterial flora ( Staphylococcus aureus, Streptococcus spp. ) in 2 3,4 times, reduces inflammation of the mucous membranes of oro and nasopharynx, adenoid hypertrophy, reduces the frequency of ARI in 1,9, 2,5 and 3,1 times respectively. In 16,6% of FIC with SAR who did not receive immunomodulators in complex treatment, persistent AR developed in a year of observation. Cases of persistent AR in groups of children receiving Superlymph or Viferon were not revealed.

The aim of this study was to examine the influence of obesity on the course of osteoarthritis (OA) in women. Material and methods: 83 women diagnosed with OA were divided into 2 groups. Group 1 (51 patients) with BMI ≥ 30 kg/m 2; Group 2 (32 patients) with BMI <30 kg/m 2. Objectification of symptoms was achieved by using a VAS (visual analogue scale) and index WOMAC. Blood levels of Creactive protein (CRP) and interleukin6 (IL6) also determined. Results: moderate direct relationship between BMI and severity of pain by VAS (r = 356, p = 0,027) was revealed. Excessive body weight (group 2) was established a very close relationship between the change in the index of pain by VAS and difficulties in performing daily activities (B WOMAC) (r = 0,971, p = 0.28). In both groups of patients with OA, regardless of BMI, there was the high level of CRP and IL6. Women with a degenerativedestructive joint disease obtained a very close relationship between IL6 and severity of pain by VAS (r = 0,99; p = 0,23). In patients with OA 2 groups revealed a strong relationship (r = 0,84, p = 0.002) between the rates of CRP and IL6 and significant relationship (r = 0,67, p = 0.006) between these same indicators in women with BMI <30 kg/m 2. Conclusions: The course of OA in women with excessive body weight is accompanied by more marked pain syndrome, increased levels of biomarkers of systemic inflammation, significant functional impairment and frequent development of synoviitis of the knee.

Objectives: To investigate genetic and neurohumoral determinants of chronic heart failure (CHF) development and progression in ischaemic heart disease (IHD) patients. Methods: Serum neurohormone level analysis (angiotensin II, aldosterone, endotheline1, NTproBNP, TNFα) and genotyping (genes encoding ACE, angiotensinogen, and type1 angiotensin II receptors ) were implemented in 100 patients Results: Activation of endotheline and NTproBNP is characteristic of early CHF stages while decompensation of chronic heart failure shows elevation in aldosterone and TNFα . Structural polymorphism of renineangiotensine system genes is not significant in CHF development and progression in IHD patients.

Blood concentration of hormones – stress indicators has been studied in patients with metastatic brain disease at pretreatment stage. Pronounced deviations of glucocorticoid and thyroid homeostasis have been observed in these patients. Dependence of hormonal parameters dynamics on extension of cerebral and extracranial metastasizing has been revealed.

В заключение выпуска журнала Федерального медико-биологического агентства «Клиническая практика», отражающего работу ФГУ «Южный окружной медицинский центр ФМБА России», публикуем небольшое эссе об Антоне Павловиче Чехове. В минувшем 2010 г. нашего именитого земляка особенно часто вспоминали в связи со 150-летием со дня рождения.