[Role of innate immunity receptors in development of acute myocardial infarction].

AIM: To assess influence of toll-like receptors (TLR) ligands on the production of proinflammatory cytokine (TNFalpha) by peripheral blood mononuclear cells in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: Peripheral blood mononuclear cells (PBMC) obtained from 13 patients with AMI on 1st and 14th day and from 17 healthy donors were stimulated by peptidoglycan, poly(I:C), lypopolysacchide, zimozan, flagellin and CpG oligodeoxynucleotides, which are ligands of TLR1/2, TLR3, TLR4, TLR2/6, TLR5 and TLR9 respectively. Spontaneous and induced by ligands production of TNFalpha was evaluated in supernatants of PBMC. RESULTS: Increased spontaneous production of TNFalpha by PBMC in patients with AIM was revealed on 1st day of the disease. Ligands of TLR2/6 and TLR4 demonstrated marked stimulatory effect on the production of TNFalpha by PBMC in patients with AMI compared with group of healthy subjects. CONCLUSION: Increased production of TNFalpha by PBMC in patients with AMI indicates the activation of TLR2 and TLR4 on PBMC. Hyperactivation of TLRs during acute pathologic conditions results in excessive production of proinflammatory cytokines, specifically TNFalpha, and can induce damage of cells and tissues involved in acute pathologic process.

[Ribosomal repeat in the cell free DNA as a marker for cell death].

We have developed a novel method for in vivo evaluation of cell death in patients with acute and/or chronic heart diseases, which are accompanied by apoptosis or cell necrosis. The method is based on the analysis of cell free DNA (cfDNA) in the blood serum (or plasma). The major parameters assessed in the method include total concentration of serum cfDNA, concentration of serum ribosomal repeat (rDNA), content of rDNA in total cfDNA, as well as factors of cfDNA elimination, such as nuclease activity and anti-DNA antibody. We demonstrated a fivefold increase in the serum cfDNA concentration and a 12-fold enhancement of serum rDNA concentration in patients with acute myocardial infarction compared with healthy individuals. In chronic coronary ischemia the serum cfDNA concentration was similar to that in the disease-free group. However, the content of rDNA in cfDNA was 4.8-fold higher, and the serum rDNA concentration was increased sevenfold. We hypothesize that one reason for accumulation of rDNA within cfDNA might be the previously reported resistance of rDNA to the ds-fragmentation by serum endonucleases. In both acute and chronic coronary disease the nuclease activity in the serum was substantially higher than that in the healthy cohort. Moreover, the titer of anti-DNA antibodies was elevated, with these antibodies being mostly bound to the cfDNA. Thus, the release of rDNA fragments into the blood not only reflects cellular death in the body but also determines the response of the organism to the disease-associated stress.

[Diagnosis and surgical treatment of distal congenital intestinal aganglionosis in children]. / Diagnostika i khirurgicheskoe lechenie distal'noi formy vrozhdennogo aganglioza kishechnika u detei.

The article contains the analysis of the additional diagnostic methods in children with Hirschsprung's disease. The main role belongs to the histobiochemical investigation of the rectal mucosa that can help to estimate acetylcholinesterase activity for the diagnosis of distal aganglionosis. The results of 100 biopsies in 93 children with chronic obstipation were examined. The analysis helped to find correlation between chronic constipation and activity of acetyicholinesterase. The use of hystobiochemical method helped to determine the distal form of congenital aganglionosis in 20 children. 10 patients had surgery with good results in short-term postoperative period.

[Correction of postoperative fecal incontinence in children]. / Sposoby korrektsii posleoperatsionnogo nederzhaniia kala u detei.

The results of surgical treatment of II-III degree incontinence of feces in 6 patients previously operated on for anorectal anomaly are presented. Clinico-functional examination permitted topical verification of damage to rectal sphincter apparatus. Sphincterolevatoroplasty with the use of a posterior sagittal approach was performed. The given approach permitted maximum use of the preserved muscular elements of the obturator apparatus. In a number of cases sphincterolevatoroplasty was combined with smooth muscle plasty of the internal anal sphincter from the distal colon. The functional results followed in 5 patients were considered as good and satisfactory ones.

[Thromboresistant properties of polyelectrolyte complexes based on weak polyelectrolytes]. / Thromborezistentnye svoístva poliélektrolitnykh kompleksov na osnove slabykh poliélektrolitov.

Thrombogenic resistant polyelectrolyte compositions were obtained on the basis of weak polyelectrolytes used in different quantity proportions. The investigations were performed in vitro on rabbit blood and in vivo on 21 dogs and 5 calves in the conditions of acute and chronic experiments. The optimal compositions of polymers were selected for the implantation. The appropriate polyelectrolyte compositions on the basis of weak polyelectrolytes, and polymers modified by polyacryl acid with polyethylene piperazine (1:1, 2:1, 3:1), were found to be thrombogenic resistant and did not cause any significant blood cells damage. The investigations performed the possibility for their practical application.

[Change in catecholamine and acetylcholine concentration in myocardial tissue in assisted circulation]. / Izmenenie kontsentratsii katekholaminov i atsetikholina v tkani miokarda pri vspomogatel'nom krovoobrashchenii

The authors stress the importance of reactions associated with the concentration of biologically active substances in the body tissues, in particular their influence on the contractility and escitability of the heart muscle. They cite the results consequent upon a study on the catecholamines and acetylcholine content in the myocardial tissue of the left ventricle and left auricle of the heart before and after institution of an auxilliary circulation effected with the aid of a valveless pump connected to the subclavicular artery in 22 dogs. An analysis of the results demonstrated that by producing counter-pulsation with the pump the concentration of catecholamines and acetylcholine in the tissues of the left head diminishes, but the fall of the catecholamines concentration does not reach the level typical of cardiac insufficiency. The authors believe that investigations of this kind may help elaborate optimal conditions and a permissible duration of the auxilliary circulation.