[Prognostication of the puncture-draining sanation interventions efficacy performed under ultrasound investigation guidance for severe acute pancreatitis].

The results of treatment of 47 patients, in whom the focal accumulations of liquid (FAL) have appeared in severe acute pancreatitis (SAP), were analyzed. The puncture-draining sanation (PDS) was performed in all the patients. In 61.7% patients the PDS under ultrasonographic guidance have appeared the one-staged definite procedure. The staged PDS were conducted in 10.6% patients. In 27.6% patients after conduction of PDS under ultrasonographic guidance there was open necrsequesterectomy performed. There was a scale elaborated for the PDS efficacy estimation under ultrasonographic guidance. Dynamic estimation of the PDS efficacy in presence of FAL in patients, suffering SAP, have had promoted the treatment results improvement. The PDS efficacy depends on the disease duration, the infiltrate spreading, the sequesters presence and the FAL infectioning.

[The influence of beta-adrenoblocking therapy on the markers of systemic inflammation in patients with acute coronary syndrome].

The study was designed to estimate activity of a series of anti-inflammatory markers (C-reactive protein (CRP), ceruloplasmin, haptoglobulin, interleukin (IL)-4, and IL-8) in the acute phase of acute coronary syndrome (ACS) and effect of beta-adrenoblocking therapy on their activity. The patients were divided into 2 groups: one was treated with beta-blocker metoprolol tartrate as a main component of ACS pharmacotherapy (n = 30), the other included the patients with absolute contraindications to bena-adrenoblockers (n = 15). Otherwise, patients of both groups received standard antianginal therapy including nitrates, anticoagulants, ACE inhibitors, and statins. The frequency of prescription of these drugs and coronary angioplasty was comparable in both groups. It was shown that patients with ACS have elevated levels of CRP, haptoglobulin and prooxidant marker ceruloplasmin.

Type IIA procollagen containing the cysteine-rich amino propeptide is deposited in the extracellular matrix of prechondrogenic tissue and binds to TGF-beta1 and BMP-2.

Type II procollagen is expressed as two splice forms. One form, type IIB, is synthesized by chondrocytes and is the major extracellular matrix component of cartilage. The other form, type IIA, contains an additional 69 amino acid cysteine-rich domain in the NH2-propeptide and is synthesized by chondrogenic mesenchyme and perichondrium. We have hypothesized that the additional protein domain of type IIA procollagen plays a role in chondrogenesis. The present study was designed to determine the localization of the type IIA NH2-propeptide and its function during chondrogenesis. Immunofluorescence histochemistry using antibodies to three domains of the type IIA procollagen molecule was used to localize the NH2-propeptide, fibrillar domain, and COOH-propeptides of the type IIA procollagen molecule during chondrogenesis in a developing human long bone (stage XXI). Before chondrogenesis, type IIA procollagen was synthesized by chondroprogenitor cells and deposited in the extracellular matrix. Immunoelectron microscopy revealed type IIA procollagen fibrils labeled with antibodies to NH2-propeptide at approximately 70 nm interval suggesting that the NH2-propeptide remains attached to the collagen molecule in the extracellular matrix. As differentiation proceeds, the cells switch synthesis from type IIA to IIB procollagen, and the newly synthesized type IIB collagen displaces the type IIA procollagen into the interterritorial matrix. To initiate studies on the function of type IIA procollagen, binding was tested between recombinant NH2-propeptide and various growth factors known to be involved in chondrogenesis. A solid phase binding assay showed no reaction with bFGF or IGF-1, however, binding was observed with TGF-beta1 and BMP-2, both known to induce endochondral bone formation. BMP-2, but not IGF-1, coimmunoprecipitated with type IIA NH2-propeptide. Recombinant type IIA NH2-propeptide and type IIA procollagen from media coimmunoprecipitated with BMP-2 while recombinant type IIB NH2-propeptide and all other forms of type II procollagens and mature collagen did not react with BMP-2. Taken together, these results suggest that the NH2-propeptide of type IIA procollagen could function in the extracellular matrix distribution of bone morphogenetic proteins in chondrogenic tissue.

[Intensive care and anesthetic maintenance in intra-abdominal hypertension].

The purpose of this review to show recent advances in the treatment of intraabdominal hypertension and abdominal compartment syndrome and to evaluate their clinical implication. To identify relevant publications, the authors have looked through the MEDLINE, EMBASE, and Cochrane Library for the original papers published since 1980. As search terms, they used "intraabdominal pressure", "intraabdominal hypertension", "abdominal compartment syndrome combined with treatment". The cumulative analysis of recent data indicates that early treatment of intraabdominal hypertension can prevent the development of abdominal compartment syndrome and a need for emergency laparotomy. However, laparotomy and various laparostomic techniques remain the only effective methods in treating intraabdominal hypertension in the presence of the abdominal compartment syndrome. The staf of surgical and general intensive care units should be aware of the prevention and treatment of intraabdominal hypertension and abdominal compartment syndrome.

[On the occasion of the 20th anniversary of the accident on the Chernobyl NPP: medical consequences in Armenia].

The aim of this work is the analysis of the indices of the health and of the structure of the sicknesses of the inhabitants of Armenia who took part in the liquidation of the consequences of the Chernobyl accident. Also it is the determination of possible dependence of the frequency of diseases for the most widespread classes of sicknesses on the received dose of the irradiation, according to the data of the clinical examination and dispensarysation; and also it is the revelation of the role of other factors influenced on the health indexes.

[The influence of some elicitors on growth and morphogenesis of Hypericum perforatum callus cultures].

We studied the effects of elicitors, such as mannan, beta-1,3-glucan, ancymidol, and cork crumbs, on morphogenetic and biosynthetic potencies of shoot cultures of Hypericum perforatum L. In the presence of these elicitors, different morphogenetic structures of H. perforatum callus cultures were formed. A correlation was found between the morphogenetic processes and induction of hypericin and pseudohypericin biosynthesis in the callus cultures.

[The species composition of mosquitoes and ticks in Armenia].

Comprehensive epidemiological, entomological, virological, and parasitological studies were conducted to examine the species composition and size of bloodsucking arthropoda (mosquitoes and ticks). A total of 64,567 mosquitoes and 45,180 Ixodes ticks were collected. Among the mosquitoes, Anopheles maculipennis was a prevalent species (81.6%). In all climatic zones, Dermacentor marginatus was the largest in number and most abundant during flag collections from cattle and plants (62.5% and 95.5%, respectively). Virological studies of the collected field material identified 125 strains of arboviruses belonging to 10 viruses: Tyaginya, Sindbis, Batai, Dkhori, tick-borne encephalitis, West Nile fever, Tamdy, KGL, Geta, and Bkhandzha. The identified arboviruses are environmentally associated with both mosquitoes and ticks. The larger number and diversity of bloodsucking artropoda present a potential risk of outbursts of arbovirus infections on the territory of the republic.

A receptor-like inositol lipid phosphatase is required for the maturation of developing cochlear hair bundles.

A screen for protein tyrosine phosphatases (PTPs) expressed in the chick inner ear yielded a high proportion of clones encoding an avian ortholog of protein tyrosine phosphatase receptor Q (Ptprq), a receptor-like PTP. Ptprq was first identified as a transcript upregulated in rat kidney in response to glomerular nephritis and has recently been shown to be active against inositol phospholipids. An antibody to the intracellular domain of Ptprq, anti-Ptprq, stains hair bundles in mice and chicks. In the chick ear, the distribution of Ptprq is almost identical to that of the 275 kDa hair-cell antigen (HCA), a component of hair-bundle shaft connectors recognized by a monoclonal antibody (mAb) that stains inner-ear hair bundles and kidney glomeruli. Furthermore, anti-Ptprq immunoblots a 275 kDa polypeptide immunoprecipitated by the anti-HCA mAb from the avian inner ear, indicating that the HCA and Ptprq are likely to be the same molecule. In two transgenic mouse strains with different mutations in Ptprq, anti-Ptprq immunoreactivity cannot be detected in the ear. Shaft connectors are absent from mutant vestibular hair bundles, but the stereocilia forming the hair bundle are not splayed, indicating that shaft connectors are not necessary to hold the stereocilia together; however, the mice show rapid postnatal deterioration in cochlear hair-bundle structure, associated with smaller than normal transducer currents with otherwise normal adaptation properties, a progressive loss of basal-coil cochlear hair cells, and deafness. These results reveal that Ptprq is required for formation of the shaft connectors of the hair bundle, the normal maturation of cochlear hair bundles, and the long-term survival of high-frequency auditory hair cells.

[Treatment of a burn stricture of the esophagus complicated with a fistula].

The experience in the treatment of esophageal fistulas is analyzed. Necessity and expediency of bougienage of esophageal burn stricture in patients with fistulas are discussed, indications and contraindications to bougienage of esophageal stricture complicated with a fistula are formulated. Surgical treatment of these patients (disfunction of esophageal fistulas and different variants of esophagoplasty) are considered.

Type IIA procollagen amino propeptide is localized in human embryonic tissues.

Type II procollagen is synthesized in two forms generated by the alternative splicing of its precursor mRNA. The alternatively spliced domain, exon 2, encodes the 69-amino-acid cysteine-rich region of the NH2 propeptide. Studies of mRNA expression have shown that the longer form, designated Type IIA procollagen, is synthesized by chondroprogenitor cells and various noncartilaginous tissues. The shorter form, Type IIB procollagen, is synthesized by differentiated chondrocytes. As the initial step in our investigations of the function of the Type IIA procollagen, the protein domain corresponding to exon 2 was created as a recombinant fusion protein and used to raise antibodies in rabbits. The resulting antiserum was specific for Type IIA procollagen NH2 propeptide as shown by ELISA, Western blotting, and immunofluorescent co-localization with the triple-helical domain of Type II collagen. Type IIA procollagen was identified in tissue culture medium of 54-day human fetal ribs. Confocal microscopy was used to localize the Type IIA NH2 propeptide in Day 50 and 53 human embryos. In the digital rays of the developing hand, where only Type IIA procollagen mRNA was detected, Type IIA procollagen NH2 propeptide was observed in the extracellular matrix. The presence of Type IIA procollagen NH2 propeptide was observed in the cartilage of the developing long bones of the lower arm and vertebral bodies even though these tissues synthesize Type IIB mRNA at this developmental stage. Type IIA procollagen NH2 propeptide was localized in the developing trachea, a cartilage that does not undergo endochondral bone formation. Type IIA NH2 propeptide was also localized in noncartilaginous tissues known to synthesize Type IIA mRNA, such as the intervertebral area, perichondrium, notochordal sheath, and neuroepithelium of the otic vesicle. In most tissues, co-localization with antiserum against the triple-helical domain of Type II collagen was observed. Positive immunoreactivity with the Type IIA NH2 propeptide antiserum indicates, for the first time, that this propeptide is present in the tissue. Co-localization of NH2 propeptide antibodies with the triple-helical domain of the collagen molecule suggests that Type IIA procollagen is intact in the extracellular matrix of these tissues. Taken together, these results strongly suggest that around cells that synthesize Type IIA procollagen mRNA, Type IIA procollagen NH2 propeptide is secreted and deposited into the extracellular matrix. In light of these results, we predict that Type IIA procollagen plays a role in differentiation of tissues that augments its purely architectural function.

Long term dietary indole-3-carbinol inhibits diethylnitrosamine-initiated hepatocarcinogenesis in the infant mouse model.

Indole-3-carbinol (I3C), a natural component from cruciferous vegetables, has been demonstrated to be a modulator of carcinogenesis in various animal models. Along with the promising perspectives of I3C as a possible chemopreventive agent for human breast cancer, some concerns have been raised regarding the tumor-promotional potency of this compound in other target organs. In this study we examined the hepatic tumor-modulatory properties of I3C fed to C57BL/6J mice, initiated with diethylnitrosamine (DEN). Infant male mice were initiated with 0, 2 or 5 mg/kg DEN (i.p. injection) at 15 days of age. Mice were weaned 9 days later and immediately put on AIN76A semipurified diet (with no antioxidants) containing 0 or 0.15% (1500 ppm) I3C. In addition, at the age of 2 months, one group of mice initiated with 2 mg/kg DEN was injected i.p. with a single dose (20 mg/kg) of 3,4,5,3',4',5'-hexachlorobiphenyl (HCB), to serve as a positive control group for promotion. Mice were sampled for hepatic tumors at the age of 6 or 8 months. Each sampled group contained 11-12 mice except the HCB group (nine animals). After 8 months, there was a statistically significant (P < 0.0005) inhibition of hepatocarcinogenesis observed for I3C-fed animals initiated with the high dose of DEN. A single injection of HCB at 2 months of age significantly (P = 0.0003) enhanced hepatocarcinogenesis in mice initiated with 2 mg/kg DEN. There was no statistically significant difference between groups sampled at 6 months of age. Our observations indicate that long term administration of I3C in the diet inhibits DEN-initiated hepatocarcinogenesis in the infant mouse model.

A new model of retinal pigment epithelium transplantation with microspheres.

OBJECTIVES: To develop a 3-dimensional carrier system for subretinal transplantation of human fetal retinal pigment epithelial (HFRPE) cells and to assess their growth pattern in the rabbit subretinal space. METHODS: After a standard 3-port vitrectomy, HFRPE cells grown as microspheres on cross-linked fibrinogen were introduced into the subretinal space of rabbits. The eyes were studied at 7, 14, and 30 days after surgery by ophthalmoscopy and light microscopy. RESULTS: Ophthalmoscopically, at day 7, 11 (61%) of the 18 eyes showed radiating hyperpigmentation around the transplanted HFRPE microspheres. The results of a histological examination revealed a monolayer outgrowth of HFRPE cells, overlying host retinal pigment epithelium. The control eyes revealed a patch of chorioretinal atrophy with lymphocytic infiltration around the microspheres. CONCLUSIONS: Human fetal retinal pigment epithelial cells grown as microspheres on cross-linked fibrinogen can be successfully transplanted into the subretinal space. Cells can survive for at least 1 month and form a monolayer over the host retinal pigment epithelium cells, with a mild local inflammatory response. The difference in inflammatory responses between the eyes that underwent transplantation and the control eyes may suggest a modulating effect of the HFRPE cells on inflammation, immunity, or both. This new xenogenic model may have importance in the study of subretinal transplant cell biology and the associated immune response. CLINICAL RELEVANCE: The results of this study may be important for better understanding of the mechanisms of retinal pigment epithelium cell behavior after transplantation. The proposed model may be applicable for future clinical and experimental investigations in the area of retinal pigment epithelium transplantation.

Retinal pigment epithelial wound healing in vivo.

OBJECTIVE: To develop an in vivo rabbit model of retinal pigment epithelial wound healing that preserves the overlying retina. METHODS: Hydraulic débridement of the retinal pigment epithelium was performed in one eye of 35 pigmented rabbits by means of a pars plana vitrectomy approach. Five of the 35 eyes were examined by stereoscopic color fundus photography, fluorescein angiography, and light microscopy on each of the following postoperative days: 0, 2, 4, 7, 14, 28, and 56. RESULTS: Retinal pigment epithelial débridement with this technique results in apical decapitation of the retinal pigment epithelial cells followed by subsequent hydraulic removal of the residual nucleus-containing basal cellular debris. The retinal pigment epithelium-denuded Bruch's membrane was resurfaced mostly by a monolayer of flattened, hypopigmented retinal pigment epithelial cells within 4 days after débridement. Progressive retinal pigment epithelial hyperplasia also occurred beginning between postoperative days 2 and 4. CONCLUSIONS: Retinal pigment epithelial wound healing after hydraulic débridement occurs rapidly and in a manner initially consistent with sliding migration. Progressive retinal pigment epithelial hyperplasia also occurs and may contribute to this repair process. Further investigation of retinal pigment epithelial repair by means of this in vivo model may provide important insight into the pathogenesis and treatment of outer retinal disorders.

Effect of intravitreal administration of indomethacin on experimental subretinal neovascularization in the subhuman primate.

OBJECTIVE: To examine the effect of indomethacin, a cyclooxygenase (CO) inhibitor, on laser-induced subretinal neovascularization (SRN) in the monkey. The CO pathway of arachidonic acid metabolism plays an important role in angiogenesis, and the inhibition of CO is known to inhibit angiogenesis in the cornea and in certain tumors. MATERIALS AND METHODS: A cannula was implanted into the vitreous cavity of 11 eyes of six monkeys and connected to an osmotic minipump. Indomethacin (25 micrograms/d) was delivered into the vitreous through the cannula for 14 days (seven eyes). Vehicle alone was injected for 14 days as a control (four eyes). Argon laser photocoagulation was then performed (eight spots at the posterior pole in each eye) to induce SRN. Fundus photographs and fluorescein angiograms were taken periodically to document the evolution of SRN. Light and electron microscopic examination was performed on two eyes of each group 8 weeks after photocoagulation. RESULTS: Subretinal neovascularization developed from 2 to 4 weeks after photocoagulation. The incidence of SRN, indicated by fluorescein leakage, was significantly lower (P < .05) in the group treated with indomethacin (14.3%, eight of 56 lesions) than in the control group (37.5%, 12 of 32 lesions). After 8 weeks, no fluorescein leakage was found in either the control or indomethacin-treated groups. Scar formation was found on histologic examination in both groups. No histologic evidence of indomethacin toxicity was seen in the adjacent retina. CONCLUSIONS: Intravitreal administration of indomethacin inhibits the formation of laser-induced SRN in monkey eyes. This is consistent with the participation of the CO pathway in the process of SRN formation and suggests that this pathway could be a potential target in the treatment of SRN.

Collagen gel contraction induced by retinal pigment epithelial cells and choroidal fibroblasts involves the protein kinase C pathway.

Contraction of intraocular fibrous membranes is an important feature in the pathogenesis of retinal detachment in proliferative vitreoretinopathy (PVR). Collagen gel contraction is a useful in vitro model of membrane contraction in PVR. We studied the role of protein kinase C (PKC) in collagen gel contraction induced by bovine choroidal fibroblasts and retinal pigment epithelial (RPE) cells. Collagen gels embedded with the cells were formed in culture dishes and gel contraction was evaluated. The PKC stimulator, phorbol 12-myristate 13-acetate (PMA), and the protein phosphatase 1 and 2A inhibitor, okadaic acid (OA), were used to evaluate the role of the PKC-mediated phosphorylation system in this gel contraction. Fifteen min incubation with PMA stimulated gel contraction, but 180 min incubation had no effect. Choroidal fibroblast- but not RPE cell-induced gel contraction was stimulated by OA. These effects were inhibited by the broad spectrum protein kinase inhibitor staurosporine and the specific PKC antagonist calphostin C. Transforming growth factor-beta (TGF-beta)1 and TGF-beta 2, which are known to be present in eyes with PVR, were evaluated to determine their effect on gel contraction. Both TGF-beta 1 and 2 had a stimulatory effect on contraction of gels seeded with choroidal fibroblasts and RPE cells, but staurosporine and calphostin C inhibited this TGF-beta-induced gel contraction. These results indicate that activation of PKC/protein phosphorylation is an important factor in gel contraction caused by choroidal fibroblasts and RPE cells, and that TGF-beta-induced gel contraction is mediated at least in part via the PKC pathway.

Reconstruction of a complex defect of the hand with two distinct segments of the scapula and a scapular fascial flap transferred as a single transplant.

To repair multiple defects of the metacarpal bones in combination with skin defects, a combined scapular free flap on a single vascular pedicle--the subscapular artery and the accompanying veins--can be used successfully. This flap includes two distinct bone segments of the lateral border of the scapula and a scapular fascial flap. Because of its long and mobile vascular pedicle, such a transplant can be used for one-stage reconstruction of the first and other metacarpal bones of the long fingers of the hand. The scapular fascial flap included in the transplant provides good functional and aesthetic results in combined injury of the skin of the hand.

Role of FGF9 and FGF receptor 3 in osteochondroma formation.

Osteochondromas are chondro-osseous protuberances that occur in metaphyses of long bones. The cartilaginous cap is assumed to be responsible for the growth of the lesions during childhood and adolescence, but mitotic figures are rarely seen in the cap. Therefore, another cell population, probably mesenchymal cells, is responsible for proliferation and growth. Residual mesenchymal cells capable of rapid proliferation are difficult to detect due to lack of specific histologic features. Two specific markers for mesenchymal cells, FGF receptor 3 (FGFR3) and collagen type IIa, have been described. Osteochondroma mesenchymal cells are found in the soft tissues overlying the cartilage cap. The surrounding areas of typical cartilage are negative for both mesenchymal cell associated antigens. The soft tissues overlying the cartilage do not have cartilaginous features. The undifferentiated cells overlying the exostosis yield in culture a rapidly proliferating homogenous population of fibroblast-like cells. Expression at the mRNA level of FGF9, FGFR3, and collagen type IIa is found in these cells, but not in skin fibroblasts from afflicted or healthy individuals. Exogenous administration of TGFbeta1 to cultures of hereditary multiple exostosis eliminates FGF9 expression. These results indicate fibrous regions contain the mesenchymal cells responsible for osteochondroma growth.

[Membranotropic effects of electromagnetic radiation of extremely high frequency on Escherichia coli]. / Membranotropnye éffekty élektromagnitnogo izlucheniia kraine vysokikh chastot na Escherichia coli.

It was found that "sound" electromagnetic radiations of extremely high frequencies (53.5-68 GHz) or millimeter waves (wavelength range of 4.2-5.6 mm) of low intensity (power density 0.01 mW) have a bactericidal effect on Escherichia coli bacteria. It was shown that exposure to irradiation of extremely high frequencies increases the electrokinetic potential and surface change density of bacteria and decreases of membrane potential. The total secretion of hydrogen ions was suppressed, the H+ flux from the cytoplasm to medium decreased, and the flux of N,N'-dicyclohexylcarbodiimide-sensitive potassium ions increased, which was accompanied by changes in the stoichiometry of these fluxes and an increase in the sensitivity of H+ ions to N,N'-dicyclohexylcarbodiimide. The effects depended on duration of exposure: as the time of exposure increased, the bactericidal effect increased, whereas the membranotropic effects decreased. The effects also depended on growth phase of bacteria: the irradiation affected the cells in the stationary but not in the logarithmic phase. It is assumed that the H(+)-ATPase complex F0F1 is involved in membranotropic effects of electromagnetic radiation of extremely high frequencies. Presumably, there are some compensatory mechanisms that eliminate the membranotropic effects.

[State of hemodynamics, function and perfusion of the myocardium in patients with arterial hypertension with different degree of left ventricular hypertrophy]. / Sostoianie gemodinamiki, funktsii i perfuzii miokarda u bol'nykh arterial'noi gipertoniei s razlichnoi stepen'iu gipertrofii levogo zheludochka.

Seventy eight patients with arterial hypertension were examined by echo-, radiocardiography and scintigraphy of the myocardium, using 99mTc pyrophosphate and 201Tl. A relationship was found between the development of hypertrophy of the left ventricle and the impairment of it perfusion and function. At the same time there was a correlation between the decrease in cardiac output and the deterioration of myocardial blood supply. It was demonstrated that 99mTc pyrophosphate or 201Tl myocardial scintigraphy yielded the coincident results when relative heart failure was evaluated in patients with arterial hypertension and left ventricular hypertrophy.