[State of the venous outflow from the small pelvis after surgical correction of pelvioperineal reflux]. / Sostoianie venoznogo ottoka iz malogo taza posle khirurgicheskoi korrektsii pel'vio-perineal'nogo refliuksa.

OBJECTIVE: The study was aimed at assessing the venous outflow from the small pelvis after surgical correction of pelvioperineal reflux with the use of reference methods of examination. PATIENTS AND METHODS: We examines a total of 43 female patients (aged 41.5±5.2 years) presenting with pelvic varicose veins and subjected to phlebectomy on the external genitalia, perineum and lower limbs. All women had no evidence of pelvic venous plethora. All women underwent the following examinations: ultrasonographic angioscanning of pelvic and lower-limb veins, emission computed tomography of pelvic veins prior to operation, as well as 1, 6 and 12 months after surgical interventions. We evaluated efficacy of phlebectomy in elimination of pelvioperineal reflux and varicose syndrome, the frequency of detecting valvular insufficiency of pelvic and lower-limb veins, dynamics of the coefficient of pelvic congestion syndrome in the immediate and remote postoperative periods. RESULTS AND DISCUSSION: No cases of relapses of valvular, perineal varicosity, repeat appearance of varicose veins on the lower extremities, occurrence of signs of pelvic venous congestion were revealed. The frequency of detecting valvular insufficiency of the parametrial, uterine, gonadal and iliac veins remained unchanged. The coefficient of pelvic congestion syndrome did not alter either (Cpcs=0.8±0.11 at baseline versus Cpcs=0.78±0.1 after 12 months). CONCLUSION: The obtained results are indicative of a steady state of the venous outflow from the small pelvis in women with pelvic varicose veins and pelvioperineal reflux after surgical removal of vulvar, perineal and superficial femoral veins.

[Micronized purified flavonoid fraction in treatment of pelvic varicose veins].

Presented herein are the results of studying efficacy of micronized purified flavonoid fraction (MPFF) in treatment of pelvic varicose veins (PVV) using reference ray-tracing methods of study. We examined a total of 85 patients with PVV. Of these, 65 subjects were found to have isolated dilatation of pelvic venous plexuses (study group), and 20 were diagnosed as having combined dilation of gonadal veins and venous plexuses of the pelvis (control group). Besides clinical examination, the patients were subjected to ultrasonographic angioscanning (USAS) and emission computed tomography (ECT) of pelvic veins before treatment and 2, 6, 12, 24, 36 and 60 months after the beginning of phlebotrophic therapy. Based on the findings of the clinical and instrumental studies, it was determined that MPFF was most efficient in patients with isolated dilatation of uterine and parametrial veins. In this group of patients, pelvic pain and other symptoms of the disease disappeared completely and the clinical effect persisted for a long time (up to 6-9 months). In the control group, venotonic therapy had a positive effect which was less pronounced as compared to the control group, and pelvic pain reappeared in the nearest time (up to 3 weeks) after withdrawal of MPFF.

[Prognostic value of allergic reaction indicators in the vaccination of children with chronic diseases].

To define the likelihood of development of adverse reactions and complications due to vaccination, the authors conducted clinical and laboratory studies of 115 children aged 1 to 15 years with chronic pathology (allergic diseases, pyelonephritis, immunodeficiency states), vaccinated with diphtheria and tetanus toxoids and pertussis vaccine and diphtheria and tetanus-M anatoxin and revaccinated with diphtheria and tetanus-M anatoxin. The results of the study suggested the prognostic value of allergic reaction indicators (total IgE, DA- and CA-specific IgE, vaccine sensitization detected by the basophil degranulation test) against adverse events and complications of immunization. Vaccination in children with chronic pathology in the presence of higher parameters of allergic reactions, by using hyposensitization therapy, was followed by to the formation of tense antidiphtheria and antitetanus immunity. The given data support the immunological efficiency and safety of immunization of children with chronic diseases against diphtheria and tetanus provided that hyposensitization therapy is performed, by keeping in mind the results of prior clinical and laboratory studies.

[Influence of polyoxydonium on adhesive properties of Corynebacterium diphtheriae].

AIM: To study the ability of polyoxydonium (PO) to influence on adhesive properties of C. diphtheriae. MATERIALS AND METHODS: Ability of PO to influence on adhesive properties of toxigenic and nontoxigenic strains of C. diphtheriae isolated from patients, carriers, contact persons as well as from healthy persons during prophylactic examinations of population in Rostov-on-Don and Rostov region was studied. RESULTS: It was established that addition of PO in cultivation medium always suppressed adhesive activity of C. diphtheriae. In experiments on breaking of adhesion the blocking effect of PO on adhesive characteristics of bacteria had dose-dependent pattern and was pronounced when PO was used in concentration of 1200 mcg/ml. CONCLUSION: Obtained data prove that PO has marked antiadhesive activity against both toxigenic and nontoxigenic strains of C. diphtheriae, which could be used for the treatment of diphtheria infection.

[Immunity to diphtheria in population of Rostov-on-Don city and Rostov region in recent years].

AIM: To study the magnitute of antitoxic immunity against diphtheria in different age groups of Rostov-on-Don city and Rostov region population. MATERIALS AND METHODS: Antitoxic immunity against diphtheriawas studied in children 3 - 15 years old (661 persons) and adults 16 - 59 y.o. (893 persons), which were tested during 2003 - 2007 using direct hemagglutination assay manufactured by Mechnikov Scientific Production Association "Biomed" (Moscow). RESULTS: Proportion of children 3 - 15 y.o. seropositive to diphtheria was 98.6 +/- 0.5%. Children aged 3 years and 4 - 6 years were identified as a risk group for diphtheria as they had highest proportions of non-immune persons. Proportion of immune to diphtheria in adults was 94.4 +/- 0.8%. Maximal level of protection was observed in personsaged 16 - 17and 18 - 19 years, in which the proportion of seropositive persons was 99.1 - 100%. Persons > or = 50 years old formed group of risk because persons with low or moderate titers of antitoxin were identified in this age group mostly. CONCLUSION: Obtained results provide evidence on enough high level of protection of Rostov-on-Don cityand Rostov region population against diphtheria. Group of increased risk comprised of persons aged 3 - 6 years and > or = 50 years.

[Mechanisms of immune response during diphtheria infection].

State-of-the-art data about mechanisms of immune response against diphtheria are presented. Antitoxic and antibacterial immunity as well as factors of natural resistance are characterized. Allergic and autoimmune reactions during diphtheria and their role in the development of complications are reviewed. Literature data and results of authors' studies in area of immunity against diphtheria are included in the review.

[Antidiphtheria immunity in children after immunization with adsorbed DPT vaccine and ADPT-M toxoid].

Antidiphtheria immunity in children aged 3-15 years was evaluated, depending on their age, the vaccinal preparation chosen for immunization and the immunization schedule. Adsorbed DPT vaccine was shown to have a higher immunological activity in comparison with adsorbed DT toxoid with reduced antigen content. The relationship between the tension of antidiphtheria antitoxic immunity in children and the possibility of the formation of the clinical forms of diphtheria with different severity in the patients was established. Children aged 4-6 years were considered to be a group of high risk in diphtheria morbidity, as it was among the children of this group that toxic and subtoxic forms of diphtheria were most often registered (44.9 +/- 7.1% of the examinees); in addition, a high proportion of children seronegative to this infection (26,3 +/- 2.2%) was observed in this group.

[Pathogenicity of Corynebacterium diphtheriae circulating in Rostov-on-Don City and Rostov region during interepidemic period].

Main pathogenic characteristics (toxin production, tox-gene detection, adhesiveness) of 59 strains of C. diphtheriae circulating in Rostov-on-Don city and Rostov region in 2004-2005 were studied. Study of toxigenicity of 15 tox+ C.di phtheriae strains showed full coincidence of Elek immunoprecipitation test and polymerase chain reaction (PCR). Presence of part of A-fragment of tox-gene was detected in 5 (11.4%) of 44 C. diphtheriae strains that were negative in Elek test. Hemagglutinating activity of toxin producing strains was intermediate (40%) or high (60%). Among non-toxigenic strains those with intermediate adhesiveness were predominated (45,5%), the intermediate or high adhesiveness was detected in strains positive in PCR. Obtained characteristics of C. diphtheriae can be useful for surveillance for diphtheria infection during interepidemic period.

[Functional flowmetry in determining the indications for reconstructive surgical interventions on the major arteries of the pelvis and lower limbs].

The work was based on the findings of the examination and surgical management of 69 patients with obliterating atherosclerosis of the lower limbs with various degree of chronic arterial insufficiency. The authors analyzed the main causes promoting development of early reocclusion of the bypasses and prostheses following reconstructive surgical operations. They also proved the role of high peripheral vascular resistance and, in particular, diminished functional possibilities of the microcirculatory-bed vessels in the genesis of early reocclusions in patients with chronic arterial insufficiency of the lower limbs. They also suggested a new technique of determining the carrying capacity of the microcirculatory channel, the use of which in the preoperative period makes it possible to predict development of early thrombotic complications, and in some cases to wisely abstain from carrying out a reconstructive vascular intervention due to high risk of its poor outcomes. It is preferable for such patients to undergo conservative pathogenetic preoperative therapy aimed at improving the functional possibilities of the microcirculatory vessels.

[Characteristics of the antitoxic and antibacterial immune response in children with diphtheria].

As found in this study, the development of the manifest forms of diphtheria occurred in the presence of lower levels of antitoxic antibodies, than bacterial carrier state. The level of antitoxic antibodies in all patients, irrespective of the time of their examination, was higher than that of antibacterial antibodies. In the dynamics of the disease a considerable increase in antitoxic and antibacterial antibodies was observed in localized and disseminated forms of diphtheria and, to a considerably lesser degree, in toxic and subtoxic forms of diphtheria, while not observed in the process of the formation of bacterial carrier state. The dynamics of a rise in the levels of antitoxic and antibacterial antibodies in the manifest forms of diphtheria infection made it possible to differentiate between the cases of toxigenic Corynebacterium diphtheriae carrier state and those of the disease.

[The use of chemiluminescence for assessing the physiological status of macrophages activated by pertussis preparations]. / Ispol'zovanie khemiliuminestsentsii dlia otsenki fiziologicheskogo sostoianiia makrofagov, aktivirovannykh kokliushnymi preparatami.

The work deals with the comparative analysis of oxygen-dependent metabolic processes in the peritoneal macrophages of intact and immune, mice after their interaction with whole-cell pertussis vaccine (WCPV), dialyzed pertussis antigen (DPA) and fraction 2 of this antigen. The study revealed that WCPV, DPA and its fraction 2 modulated the production of active forms of oxygen by peritoneal macrophages, evaluated by means of luminol-dependent chemiluminescence (CL). The influence of WCPV of oxygen-dependent metabolic processes in macrophages after the first contacts with them had a dose-dependent character: low concentrations activated and higher concentrations suppressed the "respiratory" explosion. The immunization of animals abolished the effect of extinguishing CL on the contact of macrophages with high doses of WCPV and essentially increased the level of their CL response to all pertussis preparations in comparison with those for intact cells. DPA and its fraction 2 were not inferior to WCPV in their capacity for inducing the "respiratory" explosion, and in high doses they essentially surpassed WCPV doses in this capacity, especially on the first contact with macrophages.

[Increased sensitivity of the parapertussis diagnostic agent]. / Povyshenie chuvstvitel'nosti parakokliushnogo diagnostikuma.

The adsorption activity of formolated sheep red blood cells can be increased by their combined treatment with low-frequency ultrasound, tannin and Tween-40. The diagnosticums thus obtained have proved to be highly sensitive and specific and can be recommended for the detection of antibodies to Bordetella parapertussis in the sera of sick children.

[Physicochemical and immunobiological properties of the dialysate antigen of Bordetella pertussis]. / Fiziko-khimicheskie i immunobiologicheskie svoistva dializatnogo antigena Bordetella pertussis.

The study of the physicochemical and immunobiological properties of B. pertussis dialysate antigen indicates that the antigen has a complex composition and possesses hemagglutinating and lymphocytosis-promoting activity, which permits further studies with a view to developing diagnostic and prophylactic preparations on the basis of this antigen.

[Problem of evaluation of the results of psychopathologic examinations]. / K probleme kvalifikatsii rezul'tatov patopsikhologicheskogo issledovaniia.

The article is concerned with the qualification of the data of a pathopsychological examination in cases rendering the differential diagnosis between schizophrenia and psychopathy difficult. The authors suggest a new method of analyzing the findings on the basis of their comparision by a number of lines, which allows the identification of additional differential diagnostic criteria. The data obtained indicate that pathological changes may be expressed not only in the form of impairment of individual functions but also in an alteration of their correlations.

[Evaluation of the indices of humoral and cellular immunity induced in mice of various genotypes by pertussis antigens]. / Otsenka pokazatelei gumoral'nogo i kletochnogo immuniteta, indutsiruemogo u myshei razlichnogo genotipa kokliushnymi antigenami.

The genetic predetermination of the level of immune reactions to the injection of corpuscular pertussis vaccine and purified soluble pertussis vaccine has been revealed. Genetic differences in the intensity of immune response are manifest in both humoral and cell-mediated immunity. C57BL/6 mice belong to strains with high responsiveness, while NIHHSFS/H and CBWA mice belong to strains with low responsiveness to Bordetella pertussis.

[Immune response in adult immunized with adsorbed DT-M anatoxin with reduced antigen content and Imovax-DT-adulte vaccine]. / Immunnyi otvet u vzroslykh, privitykh ADC-M-anatoksinom i Imovaks-DT-ad"iul't-vaktsinoi.

The comparative study of immune response after immunization of adults with adsorbed DT toxoid with reduced antigen content and Imovax-DT-adulte vaccine, as well as the safety of these preparations, was made. The study revealed that immunization of adults with adsorbed DT toxoid having reduced antigen content, made in two injections, and the injection of Imovax-DT-dulte vaccine, as well as the successive injection of these preparations, produced the same the levels of antitetanus immunity. Antidiphtheria immunity, evaluated by the number of seroconverted to diphtheria persons following two injections immunization was similar for the two preparations, while the level of antidiphtheria antibodies was higher in persons immunized with adsorbed DT toxoid. The immune stratum index was rather high among persons aged 16-29 years. This age group exhibited the highest number of persons, seropositive to both diphtheria and tetanus. Both vaccine preparations, adsorbed DT toxoid with reduced antigen content and Imovax-DT-adulte vaccine, were found to be equally capable of inducing autoimmune reactions in the vaccinees, detected by laboratory methods.

[Characteristics of the low molecular antigens of pertussis bacteria]. / Kharakteristike nizkomolekuliarnykh antigenov kokliushnykh bakterii

The authors elaborated a method of obtaining pertussis soluble antigenic complex by dialysis through the cellophane membrane against the physiological saline at a temperature of 4 degrees C. An antigen which was active in the passive hemagglutination and neutralization of antibodies tests was revealed in the dialyzate. The amount of this antigen in the dialyzate increased gradually up to the 7th day and then became stabilized. The serological activity of the antigen after evaportation increased 4-16 times. The results of the antibody neutralization test pointed to the presence in the dialysate of substances common to those contained in the 1a and 1Da fractions isolated from the pertussis bacteria with the aid of ammounium sulfate.

[Clinical importance of determining DNA antibodies in myocardial infarct and stenocardia]. / Klinicheskoe znachenie opredeleniia antitel k DNK pri infarkte miokarda i stenokardii.

Blood antibodies to DNA were investigated in 65 patients with myocardial infarction, 54 patients with angina pectoris and 19 clinically normal subjects. Antibodies to formalinized DNA could be detected with similar frequencies in both myocardial infarction and angina pectoris, although their titres were different in terms of value and pattern. Antibodies to denatured and especially native DNA were a less common finding, mostly associated with a more aggravated course of the disease. No blood antibodies could be detected in fatal cases of myocardial infarction, and in cardiogenic shock, their titres were small. The measurement of antibodies to DNA can be used for clinical assessment of the disease's course and prognosis.

[Specific immunologic diagnosis of alcoholic myocardial dystrophy]. / Spetsificheskaia immunologicheskaia diagnostika alkogol'noi miokardiodistrofii.

The paper deals with the results of specific anticardiac antibody determination in 124 patients with alcoholic damage to the myocardium (Stages I-III chronic alcoholism), 36 healthy subjects, and 33 patients with various cardiovascular diseases. It was established that specific antibodies were present in the sera from patients with alcoholic myocardial dystrophy, but absent in healthy subjects and almost completely absent in patients with cardiac diseases of other etiology. This enables the authors to recommend that specific anticardiac antibodies be identified to detect alcoholic myocardial damage. The procedure proposed provides a high diagnostic accuracy (89.2%), has no contraindications, requires no special preparation of the patient for the examination, therefore may be used both in the in- and outpatient settings.

[A comparative analysis of the effect of Bordetella pertussis preparations on a primary culture of murine peritoneal macrophages]. / Sravnitel'nyi analiz vliianiia preparatov Bordetella pertussis na pervichnuiu kul'turu peritoneal'nykh makrofagov myshei.

The paper deals with comparative analysis of the effect of corpuscular pertussis vaccine (CPV), pertussis dialysate antigen (PDA) and its fraction 2 (fr. 2 PDA) on primary culture of peritoneal macrophages of mice. It is established that CPV possesses the expressed cytotoxic effect that is of dose-dependent character. PDA and 2 (fr. 2 PDA), in contrast to CPV had not such an effect. Only very high doses of preparations (100 micrograms by protein) evoked weak toxic effect on macrophages. Strict direct correlation between cytotoxic effect of pertussis preparations on the primary culture of peritoneal macrophages of mice and their capacity to induce leukolymphocytosis that permits recommending application of these cells to estimate toxicity of pertussis preparations and prediction of potentiality of development of side effects under their introduction.