[Detection of sodium monourate crystals in biopsies of gastric mucosa in patients with gout]. / Vyiavlenie kristallov monourata natriia v bioptatakh slizistoi obolochki zheludka u bol'nykh podagroi.

AIM: To examine gastric biopsies with polarization microscopy for detection of sodium monourate crystals (SMC). MATERIAL AND METHODS: The trial included 20 patients with gout diagnosis (mean age 55.7 years, mean duration of the disease 12.3 years) in whom esophagogastroduodenoscopy was made with biopsy of gastric mucosa from the antral part of the stomach and middle third of the gastric body. RESULTS: Crystals in the biopsy specimens were detected in 11 of 20 examinees. The crystals were characterized by strong double refraction, length 3-20 mcm, acicular or planiform shape, blue or yellow color depending on position in compensated polarized light. Quantitative distribution of the crystals within one biopsy specimen was uneven and varied from solitary crystals to clusters of 70-80 crystals in sight, up to formation of tophus-like structures. Clinical picture in detection of SMC was characterized by more frequent occurrence of cases with subcutaneous tophuses of various location combined with higher hyperuricemia. CONCLUSION: One of the essential lines in the research of gout concerns mechanisms of SMC formation in organs and tissues and microcrystalline gastroduodenal inflammation. Methods of correction of this inflammation are to be designed.

[Articular lesions in Ixodes tick-borne borreliosis (Lyme disease)]. / Porazhenie sustavov pri iksodovykh kleshchevykh borreliozakh (laimskoi bolezni).

Articular lesions in 157 patients infected with ixodes tick-borne borreliosis (ITB) in a central Russia's region set on, on the average, in 4 months after tick attack; they were associated with systemic signs of an early disseminated infection and set on less seldom in a late period. The most often encountered systemic signs were as follows: secondary erythema (32% of patients), neurological syndrome (13%), cardio-vascular lesions (22%), ocular lesions (13%) and hepatic lesions (8%). The articular syndrome manifested itself through arthralgia (53 patients) and arthritis (104 patients), which set on quite often in the tick-attack area. There was a peculiarity typical of articular lesions, which made it possible to distinguish them from other rheumatic disease. A dynamic follow-up revealed different clinical variations of Lyme's arthritis and peculiarities of the genetic profile, i.e. a higher prevalence of HLA A2, HLA-B15 and HLA-DR4 as well as of haplo-types HLA A2-B15 and HLAB15-DR4. The articular lesions were associated with an intensive specific humoral immune response. The instrumental examination methods, i.e. ultrasonography of joints as well as scintigraphy of bones and joints, did not reveal any qualitative differences between arthralgia and arthritis, which is indicative of a common nature different-intensity manifestations of arthropathy in thick-borne borreliosis.

[Study of the synovial fluid in rheumatoid arthritis]. / Izuchenie sinovial'noi zhidkosti pri revmatoidnom artrite.

A comparative study of the synovial fluid (SF) composition was conducted in 72 patients with rheumatoid arthritis (RA) with relation to the presence of the rheumatoid factor (RF) and clinical manifestations of this disease. A statistically significant difference in the SF composition (the number of leukocytes, neutrophils and ragocytes) was shown in seropositive and seronegative RA. The content of total protein and glucose in SF did not practically differ in both cases. In the common group of the RA patients correlation was established between the number of neutrophils, the level of total protein, percentage of ragocytes, the level of complement in SF and a degree of general inflammatory activity of disease. A subgroup of RA patients (32%) was identified with the prevalence of lymphocytes, a slight rise of the level of total protein, a low percentage of ragocytes and rather a high level of complement. In 87% of the above patients noticeable osteochondrous destruction (III-IV roentgenological stage) was noted against a background of low inflammatory activity. The data obtained confirmed an important role of SF investigation for the elucidation of the mechanisms of pathogenesis, differential diagnosis and prognosis.

[Study of articular cartilage and the synovial membrane using IR spectroscopy]. / Izuchenie sustavnogo kriashcha i sinovial'noi obolochki posredstvom IK-spektroskopii.

The infrared spectra of normal knee joint cartilage, normal and rheumatoid arthritis-affected human synovial membrane and the same normal bovine tissues were obtained over the region of 400--4000 cm-1. A comparative analysis of the spectra of these tissues and those containing hyaluronate, protein-chondroitin-keratan sulfate aggregates of cartilage proteoglycans and heparin made it possible to identify greater absorption bands of these biopolymers in the tissue spectra. The interpretation of the results obtained is presented.

[New data on glycosaminoglycans and proteoglycans]. / Novye dannye o glikozaminoglikanakh i protoeglikanakh.

The most important investigations on glycose aminoglycans and proteoglycans, carried out within the recent 5-7 years, are reviewed. Data on primary structures repeating in glycose aminoglycans and on relationship between these biopolymers and protein components in proteoglycans are considered. Newer information on conformational characteristics of glycose aminoglycans, various complexes aggregation of proteoglycans and distribution of the biopolymers in animal tissues and cells is discussed. Properties of proteoglycans in various solutions are briefly considered.

[Clinical evaluation of delayed and immediate hypersensitivity to antigens of the connective tissue, myocardium and hemolytic Streptococcus in patients with rheumatic fever]. / Klinicheskaia otsenka immunologicheskikh reaktsii zamedlennogo i nemedlennogo tipa k antigenam soedinitel'noi tkani, miokarda i gemoliticheskogo Streptokokka u bol'nykh revmatizmom

The results of a study of some humoral and cellular immunological reactions to antigens of the myocardium and connective tissues of cardiac vlaves, as well as to those of the haemolytic Streptococcus in rheumatic patients are presented. Antibodies to 4 antigens were deter mined, to cellular form of immunity was examined by the method of leucocytes migration inhibition. The studies have indicated that in rheumatism, hupersensitivity of a delayed and non-delayed type manifests itself. The activity of the inflammatory process, its severity, the nature and severity of carditis are to a great extent reflected by the connective tissue antibodies to the basic substance, especially to the structural glycoprotein of the valves. In cases of the most unfavourable clinical forms of the rheumatic process the signs of streptococcal sensitization and autoallergy to both musclular and connective tissue cardiac structures are especially vivid.