[DYNAMICS OF INFLAMMATORY MARKERS AFTER SURGERY ON THE DISTAL RECTUM].

Objective - to compare the concentrations of inflammatory markers interleukin-6, CRP, and lactoferrin in the serum of patients with benign diseases of the rectum, depending on the volume of surgical intervention and evaluate their changes in different periods after surgery. Been surveyed 92 patients: 54 patients (control group) were operated on for one of the three diseases - chronic hemorrhoids, fistula rectum and chronic anal fissure, 38 patients (main group) operated simultaneously over two or more diseases (combined pathology), where the main were diagnosed with the above diseases. In both groups of patients was determined concentration of interleukin-6, CRP and lactoferrin in serum before surgery, on 3 and 7 days after surgery. There is no communication with the volume of intervention co-operations in the distal rectum with the severity of the systemic inflammatory response. Not identified authentic differences in changes in the concentration of inflammatory markers interleukin-6, C-reactive protein, and lactoferrin in patients operated on for one disease and in patients with combined pathology of the distal colon. The concentration of all investigated markers before operation was higher in both groups of patients diagnosed with anal fissure. The exceptions were the main group of patients with chronic hemorrhoids, in which the concentration of lactoferrin was higher than that of the same group of patients with a diagnosis of the fistula of the rectum and anal fissure. Regardless of the volume of intervention and the type of the marker in patients diagnosed with rectal fistula most pronounced inflammatory reaction was observed on 3-rd day after surgery. Regardless of the volume of operative intervention and nosology on 7-th day after the operation the majority of the studied parameters values approached preoperative, with the exception of both groups consisted of patients diagnosed with anal fissure. Increased of volume of surgical intervention does not lead to a authentic increase in performance of the inflammatory response in patients with combined pathology.

Carbamate Formation in the System (2-Methylpiperidine + Carbon Dioxide) by Raman Spectroscopy and X-ray Diffraction.

In aqueous solution, 2-methylpiperine (2-MP) has been proposed as a phase-separating amine for carbon-capture applications, whose carbamate is considered to be unstable due to steric hindrance. This paper demonstrates, for the first time, that the carbamate can be synthesized as the salt of the 2-methylpiperidinium cation (2-MPH+) and the 2-methylpiperidine- N-carboxylate anion (2-MPCOO-) by adding carbon dioxide gas to anhydrous liquid 2-MP at CO2/amine ratios α > 0.32 to yield well-defined prismatic crystals. Raman spectra have been measured for anhydrous liquid 2-MP and aqueous solutions of 2-MP and 2-MPH+Cl- at 298 K. The spectra of anhydrous liquid 2-MP, containing dissolved CO2 at lower CO2/amine ratios,. clearly showed the presence of 2-MPH+ and several unidentified bands that were attributed to the carbamate, 2-MPCOO-. Quantum chemical calculations at the B3LYP/6-311++G(d,p) level of theory yielded simulated Raman spectra consistent with the experimental spectra. The spectra show the methyl group of both liquid and aqueous 2-MP and that of aqueous 2-MPH+Cl- to be in the equatorial position. The crystal structure shows the same conformations in the solid state and confirms that Raman spectroscopy can be used to determine the conformation of 2-MP species in the liquid state and aqueous solutions.

[Individual differences in the response of target organs and the immune system in experimental endotoxicosis].

Individual morphofunctional differences were studied in the reaction of target organs and the immune system of Wistar rats given large-dose lipopolysaccharides (LPS). A cluster analysis of the indices characterizing the reaction of target organs and the immune system to PLS administration was used to divide the Wistar rats into 2 groups: 1) those with high production of Th1 cytokines (interleukin-2 and interferon-gamma) and 2) those with their low production. In the high production group, hepatic dystrophic changes and a pulmonary inflammatory reaction were more pronounced, which were associated with the alterative changes in the immune organs. On day 7, the morphofunctional differences in the reaction of target organs and the immune system were less marked and mainly seen at the functional level.

[Long-term efficacy and safety of chondroitin sulphate (structum, France) in patients with coxarthrosis].

AIM: To evaluate long-term therapeutic effect and safety of structum in patients with manifest coxarthrosis. MATERIAL AND METHODS: Twenty patients with manifest coxarthrosis of degree I-III were given a 6 month structum course. Criteria of efficacy were Leken index, pain in the affected joints, nonsteroid anti-inflammatory drugs requirement, assessment of the efficacy by the patient and the doctor. Structum effects were studied with x-ray examination, CT, INC index. The assessment was made at baseline, after 3 and 6 month therapy and 6.12 and 18 months after the end of the study. RESULTS: All the patients achieved positive results without side effects on coagulation. CONCLUSION: Structum is highly effective in patients with manifest osteoarthrosis of hip joints. Is modifies symptoms, has a potential chondroprotective effect, long-term aftereffect, no significant negative action of coagulation, is well tolerated.

[Structum therapy of patients with rheumatoid arthritis]. / Opyt primeneniia struktuma u bol'nykh revmatoidnym artritom.

AIM: To study efficacy of the chondroprotector chondroitin sulphate (structum, Pier Fabr Medicament Production, France) in patients with rheumatoid arthritis (RA) and secondary osteoarthrosis of the knee joints. MATERIAL AND METHODS: 15 women with a long history of RA (mean duration 11.9 years) entered an open non-randomized trial of structum. The patients had a severe progressive highly active RA with a definite x-ray stage of the disease. 13 patients had a positive rheumatoid factor (1:80 to 1:1280) and involved knee joints which had been affected for 1 to 10 years (mean 5.3 years). The second x-ray stage was in 8 patients, the third stage of knee joints arthrosis was in 7 ones. A marked pain syndrome in the knee joints upon movement (mean 64.7 mm by VAS) was observed in all the examinees and at rest (mean 28 mm by VAS) in 13 of 15 patients. Structum was given according to a standard scheme: 500 mg 3 times a day for 3 weeks than 500 mg 2 times a day for up to 6 months. Basic drugs for RA were the same for all the observation period. RESULTS: Structum noticeably improved knee joint function (mean Leken's index 12.8, 11.3 and 9.4 scores before the treatment, on treatment month 3 and 6. Movement pain syndrome VAS reduced from 64.7 mm at the start to 51 mm 3 months and 37.5 mm 6 months later, rest VAS--from 19 to 10.3 and 6.4 mm, respectively. The demand in intraarticular glucocorticoids went down from 52 injections at the start of therapy to 6 after 6 months. Side effects for 6 months were absent. Overall efficacy was good (73.3% and 80%) as judged by the doctors and patients, respectively. After 6 months of therapy control x-rays found no progression of destructive changes in the knee joints (by MRI--in 4 patients). CONCLUSION: Structum has a marked positive therapeutic effect in patients with severe and long-term course of RA with associated pronounced secondary joint arthrosis.

[Pain in the lower part of the spine in spinal osteochondrosis: experience in using chondroprotective drugs]. / Voli v nizhnei chasti spiny pri osteokhondroze pozvonochnika: opyt primeneniia khondroprotektivnogo preparata.

AIM: To assess the response to chondroitin sulfate (structum) in low back pain (LBP) due to spinal osteochondrosis. MATERIAL AND METHODS: 30 patients (mean age 51.4 years) with a definite primary LBP took structum in a dose 1 g/day for 24 weeks. The diagnosis was made according to WHO recommendations (2000). The response was assessed with uniform international questionnaires and visual analogue scale. RESULTS: The treatment reduced pain syndrome and improved spinal function in 73.3% patients with LBP studied. CONCLUSION: It would be valid to include long-acting chondroprotective drugs in the program of LBP in spinal osteochondrosis.

(6,17-Dimethyl-8,15-diphenyldibenzo[b,i][1,4,8,11]-tetra-aza[14]annulenato)nickel(II) in solids: two guest-free polymorphs and inclusion compounds with methylene chloride and fullerene (C(60))-carbon disulfide.

Two guest-free polymorphs and two inclusion compounds of the macrocyclic title complex [NiL] have been isolated and characterized with single-crystal and/or powder XRD, solid-state (13)C NMR, and other methods. The inclusion compound with methylene chloride, [NiL](CH(2)Cl(2)), is stable in air and thermally stable up to approximately 128 degrees C. Its crystal structure is consistent with van der Waals packing of the host [NiL] and guest CH(2)Cl(2) molecules. The host complex has square-planar coordination of the nickel(II) center with four nitrogen atoms of the macrocycle with an average Ni-N distance of 1.86 A. The molecule has a saddle-shaped conformation with the guest molecule located between one phenylene and two phenyl rings of the host molecule. Isostructural compounds with chloroform and 2-chloropropane form only as mixtures along with a guest-free host polymorph. The inclusion compound with C(60) has a composition 3[NiL]*(C(60))*2(CS(2)) and here also the crystal structure is consistent with a van der Waals type of packing. Three crystallographically inequivalent [NiL] molecules have geometries similar to that in the inclusion compound with methylene chloride. The concave surfaces of the complex molecules form a spherical cavity for the C(60) molecule. At -100 degrees C the C(60) molecule is disordered over two orientations centered at the same site. (13)C NMR studies at room temperature show that the C(60) molecule is undergoing rapid pseudo-isotropic rotation. The stability and other properties of the title and related complexes are discussed.

Novel 4-vinylpyridine-extended metal-dibenzoylmethanate host frameworks: structure, polymorphism, and inclusion properties.

In this contribution we show that host materials based on metal dibenzoylmethanates (DBM) can be extended in a versatile way by decreasing the packing efficiency of the simpler metal DBM's reported earlier. Specifically, this can be accomplished by coordinating two 4-vinylpyridines (4-ViPy) to the metal (Ni or Co) DBM units to give [M(4-ViPy)2(DBM)2] host complexes. These display a remarkable polymorphism and an ability to form inclusion compounds with a large variety of organic species. Five non-clathrate phases representing three polymorphic types and twenty-eight inclusion compounds with nineteen guests, representing five structural types were isolated and studied in varying degrees of detail. The inclusion compounds can be prepared by recrystallization or by interaction of the solid host with guest vapor. In the latter case, the process realization, kinetics and final product strongly depend on the host polymorph chosen as starting material. Kinetic studies executed with powder XRD suggest that transient formation of inclusion compounds may occur even during solvent vapor induced transformation of one guest-free polymorph to another. The beta polymorph of the Ni-host reveals the strongest clathratogenic ability as well as a high selectivity towards certain homologues and isomers. Its properties give insight into the concept of "flexible zeolite mimics", or "apohosts", as this empty host form is energetically and structurally predisposed towards inclusion processes. In all eleven (three host and eight clathrate) structures studied by single crystal X-ray diffraction the [M(4-Vi-Py)2(DBM)2] complex molecule is transconfigured. In most, the host molecules show effective packing in one dimension by forming parallel chains. Guest species are located between the chains in cages or channels formed by combining voids in the host molecules belonging to adjacent chains. The corresponding Ni and Co versions of the compounds studied were similar.

In situ switching of sorbent functionality as monitored with hyperpolarized (129)Xe NMR spectroscopy.

In this contribution, we demonstrate that a material (organic zeolite mimetic coordination polymer [CuL(2)], where L = L(-) = CF(3)COCHCOC(OCH(3))(CH(3))(2)) can be endowed with its functionality in situ under molecular-level control. This process involves the isomerization of the ligands followed by phase interconversion from a dense to an open, porous form. The porous (beta) form of the complex reveals zeolite-like behavior but, unlike zeolites and many other hard porous frameworks, porosity may be created or destroyed at will by the application of suitable external stimuli. Contact with methylene chloride vapor was used to switch on the sorbent functionality, whereas switching off was accomplished with a temperature pulse. The transformations between functionally inactive alpha and active beta forms, as well as the amount of vacant pore space, were monitored in situ by observing the NMR spectrum of hyperpolarized (HP) Xe atom probes. For methylene chloride, the chemical shift of the coabsorbed HP Xe correlated directly with the amount of adsorbate in the pore system of the open framework, illustrating the use of HP Xe for following sorption kinetics. The adsorption of propane, as an inert adsorbate, was also monitored directly with (1)H NMR, with HP Xe and by BET measurements, revealing more complex behavior.

Nickel(II) and zinc(II) dibenzoylmethanates: molecular and crystal structure, polymorphism, and guest- or temperature-induced oligomerization.

Four forms of nickel(II) and two of zinc(II) dibenzoylmethanates have been isolated and characterized with powder and single-crystal X-ray diffraction analyses, differential scanning calorimetry, magnetic susceptibility measurements, and solid-state 13C cross-polarization/magic angle spinning NMR. Nickel dibenzoylmethanate, Ni(DBM)2 (DBM = PhCOCHCOPh-), forms three polymorphic forms (light-green, brown, and green) and a fourth clathrate form with guest benzene included. The light-green polymorph is metastable. Substituted benzenes induce recrystallization of the polymorph into a stable brown form (C30H22NiO4; a = 26.502(3) A, b = 5.774(1) A, c = 16.456(2) A, beta = 116.03(1) degrees; monoclinic, C2/c; Z = 4). Unlike the other forms, the brown form is diamagnetic and is comprised of monomers of the low-spin [Ni(DBM)2] complex. The Ni(II) is chelated by two DBM ligands in a square planar environment by four donor oxygen atoms. When heated, the brown form transforms to a green form which is stable above 202 degrees C (C90H66Ni3O12; a = 13.819(2) A, b = 16.252(2) A, c = 17.358(2) A, beta = 108.28(1) degrees; monoclinic, P2(1)/n; Z = 2). This polymorph is formed by van der Waals packing of trimers [Ni3(DBM)6] containing linear Ni3 clusters with an Ni-Ni distance of 2.81 A. The cluster is surrounded by six DBM ligands, providing a distorted octahedral environment about each Ni by six oxygen atoms. Benzene stabilizes the trimeric structure at room temperature, forming a [Ni3(DBM)6].2(benzene) inclusion compound (Ni-Ni distance of 2.83 A) with guest benzene molecules located in channels (C90H66Ni3O12 + 2(C6H6); a = 17.670(2) A, b = 20.945(3) A, c=11.209(2) A, beta = 102.57(1) degrees; monoclinic, P2(1)/c; Z = 2). Zinc dibenzoylmethanate has been prepared in two polymorphic forms. The monomeric form contains [Zn(DBM)2] molecules with the zinc center in a distorted tetrahedral environment of four oxygens from the two chelated DBMs (C30H22O4Zn; a = 10.288(2) A, b = 10.716(2) A, c = 12.243(2) A, alpha = 89.19(1) degrees, beta = 75.39(1) degrees, gamma = 64.18(1) degrees; triclinic, P1; Z = 2). Another, dimeric form contains [Zn2(DBM)4] species, with two zinc atoms separated by a distance of 3.14 A and each zinc coordinated by five oxygen atoms (C60H44O8Zn2; a = 25.792(3) A, b = 7.274(1) A, c = 24.307(2) A, beta = 90.58(1) degrees; monoclinic, C2/c; Z = 4). The polymorphic variety of the title complexes and the peculiarities of the Ni(II) and Zn(II) coordination environments are discussed in the context of using the complexes as precursors for new metal complex hosts.

[Results of the multicenter clinical trial of structum preparation in Russia]. / Itogi mnogotsentrovogo klinicheskogo issledovaniia preparata struktuma v Rossii.

AIM: To study clinical effectiveness and tolerance of structum in patients with osteoarthrosis (OA) of the knee joints (KJ) and hip joints (HJ) in a multicenter open randomised trial. MATERIAL AND METHODS: A 6-month trial of effectiveness and tolerance of structum has been performed in 9 medical centers and included outpatients (males and females) with KJ OA or HJ OA satisfying the OA diagnostic criteria of the American Rheumatology College, having x-ray stage I-III according to Kellgren-Lawrence with manifest pain, a total functional Leken index from 4 to 11, regular intake of non-steroid antiinflammatory drugs (NAID) for 30 days in the last 3 months. Consent was obtained from each patient. 192 patients received structum, 363 matched patients served control. Structum was given per os for 3 weeks in a dose of 1.5 g/day then in a dose 1.0 g/day up to 6 months. The patients continued on NAID. The patients' examination was performed in the beginning of the study, at its months 3 and 6. RESULTS: Leken index in HJ and KJ OA significantly fell after 3 months of structum treatment. Up to month 6 it fell still further (p < 0.05). After 6 months of treatment pain syndrome relieved both at rest and movement, pain at rest disappeared fully in 57% of NJ OA patients and 46% of HJ OA patients, for movement pain it was 17 and 13%, respectively. During the treatment NAID intake was less required in both groups (p < 0.05) while 55% of patients in both groups could discontinue NAID after 6 months of the treatment. Tolerance of the drug was rather good, side effects were mild. CONCLUSION: Structum (chondroitin sulphate) is an effective drug for treatment of KJ and HJ OA: it relieves pain, preserves and improves articular function, allows to reduce or discontinue NAID, is well tolerated.

[Pharmacoeconomic aspects of use of structum in osteoarthrosis]. / Farmakoékonomicheskie aspekty primeneniia struktuma pri osteoartroze.

AIM: To study cost-effect efficiency of structum in patients with knee and hip joint osteoarthrosis (OA) in a multicenter trial. MATERIAL AND METHODS: The trial enrolled 192 patients with OA. 110 patients had knee joint OA and 82 patients hip joint OA. The patients received structum for 6 months. Efficacy of the treatment was assessed before use of structum and after it by standard methods. Integral effect of therapy was estimated according to the special program complex. The cost of the drug therapy included the cost of structum and nonsteroid anti-inflammatory drugs (NSAID) on conversion to 1 mg of diclofenac plus the cost of treating side effects. The efficacy per unit cost was calculated by the formula: E1xC2/E2xC1, where E1--integral efficacy of therapy before using structum, E2--integral efficacy of therapy in administration of structum, C1--cost of drug therapy, C2--cost of drug therapy in using structum. RESULTS: E2 was equal to 94% for knee joints OA and 92% for hip joint OA, E1 and C1--21 and 19%, respectively. C2 was equal to 108.43$ for knee joint OA and 106.97 for hip joint OA, C1--29.3 and 27.44, respectively. The efficacy per unit cost for knee joint OA was 94 x 29.3/21 x 108.3 = 1.21, for hip joint OA 92 x 27.44/19 x 106.97 = 1.24. The figures evidence for much higher efficacy per unit cost of structum vs routine NSAID. CONCLUSION: The multicenter trial gave grounds not only for clinical efficacy of structum vs NSAID but also for cost-effect advantage of structum in therapy of OA.

[Is the bronchial provocation test justified in occupational respiratory disease?]. / L'épreuve de provocation bronchique est-elle justifiée en pathologie respiratoire professionnelle?

Specific bronchial provocation tests can confirm the diagnosis of occupational respiratory disease and also identify the causal agent of occupational asthma. The changes in French regulations established in 1993 which allow other agents to be recognized as causal in compensation for occupational diseases has increased interest in these tests. The different diagnostic methods used for occupational asthma are discussed here with special emphasis on limitations in each case: history taking, immunological investigations, respiratory function tests, measurement of peak flow during occupational activity and holidays, sequential measurements of non-specific bronchial hyperreactivity. The difficulty in standardizing specific provocation tests used for occupational asthma is related to the wide variety of causal agents which can be inhaled as gas, aerosols or powders. Because of the required precautions, these tests must be performed by specialized personnel in hospital units. There are also limitations to specific provocation tests. False positives require placebo tests and false negatives may result from insufficient identification of the causal agent. Exposure time may be too short or concentrations too low, and may depend on how long the causal agent has been evicted. Specific provocation tests may be avoided when the clinical history reveals a typical situation due to an agent known to cause occupational asthma and repeated peak flow measurements at the working site and/or immunological sensitisation tests provide objective evidence. But in a certain number of cases, specific investigations are required to obtain the precise etiological diagnosis required to evict the allergen rapidly and avoid chronic asthma.

[Changes in blood immunochemical indices in atherosclerosis patients during combined diet and drug therapy]. / Izmeneniia immunokhimicheskikh pokazatelei krovi u bol'nykh aterosklerozom v protsesse kompleksnoi dietomedikamentoznoi terapii.

A total of 34 patients with atherosclerosis were on a prolonged combined dietetic and drug therapy. In 6 mos improved blood serum lipid indices (a decrease in the level of total cholesterol, a decrease in the level of atherogenic beta-lipoproteins and an increase in the level of antiatherogenic alpha 1-lipoproteins) and a decrease in the serum level of alpha 2-glycoproteins of the atherosclerotically changed aortic wall were observed. A decrease in angina attacks, AP stabilization, disappearance of dyspnea in physical exercise, and a decrease in excess body mass were noted. The authors emphasized the efficacy of this method for the treatment of patients with atherosclerosis.