[Agoraphobia with panic disorder combined with depression]. / Simptomokompleks agorafobii s panicheskim rasstroistvom, komorbidnyi s depressiei.

OBJECTIVE: The aim of the study was to investigate the course of agoraphobia with panic disorder combined with the major depressive disorder to establish positive and negative prevalence predictors. MATERIAL AND METHODS: The sample consisted of 49 women. The average age was 41.5±9.9 years. All patients (n=49; 100%) had symptoms of agoraphobia with panic disorder (F40.01) (n=49; 100%) and recurrent depressive disorder with mild (F33.01) (n=33; 67.3%) or moderate (F33.11) (n=16; 32.7%) severity. The duration of the disease by the time of inclusion in the study was from 2 to 5 years. Clinical-psychopathological, clinical-follow-up, clinical-dynamic, and statistical methods were used. RESULTS AND CONCLUSION: Two types of agoraphobia prevalence with panic disorder were identified. Type I is a relatively favorable one with complete remissions of phobic anxiety and affective disorders (n=29; 59.2%). Type II is an unfavorable one with constant phobic anxiety symptoms (n=20; 40.8%). The predictive factors of the unfavorable type of agoraphobia with panic disorder (APD) combined with depression were psychogenic situations, astheno-vegetative disorders at the onset of APD, gastrointestinal symptoms, senestopathy, fear of going crazy, or loss of control in the structure of a panic attack (PA), morning PA, vertebral artery syndrome, diseases of the gastrointestinal tract, panic attacks with provocation, depression with hysteroform symptoms in pre-manifest period APD, the age at the time of the debut APD, professional status, occupational psychogenic, family microclimate, health problems, endocrine system diseases, severe agoraphobia.

Caspase-3 activity in papillary thyroid carcinomas.

AIM: The aim of this work was to assess caspase-3 activity in the tissue of papillary thyroid carcinomas of patients and analyze the peculiarities of changes in this activity depending upon a number of pathomorphological and clinical features of tumoral process. METHODS: Caspase-3 activity was determined by spectrophotometry with regard to acetyl-asp-glu-val-asp-paranitroanilide. RESULTS: At initial stages of tumor development, in the absence of metastases to lymph nodes, blood and lymphatic vessel invasion by tumor cells, extrathyroid spreading of tumor, sclerotic and fibrous changes in tumor stroma, and in the presence of tumor capsule, caspase-3 activity in papillary carcinoma tissue was higher compared to unchanged thyroid tissue of normofollicular structure. In case of a more aggressive behaviour of tumor, enzyme activity in carcinoma tissue did not differ significantly or (in case of extrathyroid spreading of tumor) was decreased compared to that in extratumoral tissue. In combination, this was expressed by a progressive decrease in caspase-3 activity in tumor tissue with increasing T category. Сaspase 3 activity was found to be much higher in the tissue of papillary carcinomas of follicular-papillary structure and lower in the tissue of tumors of mixed structure with solid areas, compared to that in the tissue of papillary carcinomas of typical papillary structure. CONCLUSIONS: The data obtainеd in assessing caspase-3 activity suggest that the intensity of spontaneous apoptosis of human papillary thyroid carcinoma cells depends upon the stage and aggressiveness of tumoral process.