[Character of changes in indicators of proteinase and proteinase inhibitor activity in gastroenterological pathology in children]. / Kharakter izmenenii pokazatelei aktivnosti proteinaz i ikh ingibitorov pri gastroénterologicheskoi patologii u detei.

The aim of this study was to determine trypsin-lake proteinase activity, chymotrypsin-like proteinase activity, trypsin, alpha 1-antitrypsin and alpha 2-macroglobulin levels in blood serum at the children with gastroenterological pathology. These parameters did not chang at the children with functional disorder of stomach and duodenum. The stable balance between proteinases and inhibitors was determined only at the duration of the disease not more 5 years. The absence of normal levels these enzymes after traditional treatment was explain the necessity to continue the therapy at home with control of enzymes' levels.

[Serine proteinase activity in children with hemolytic-uremic syndrome]. / Aktivnost' serinovykh proteinaz u detei s gemolitiko-uremicheskim sindromom.

Haemolytic-uremic syndrome (HUS) is the leading cause of acute renal failure in the childhood. It is characterised by microangiopathic hemolytic anemia, thrombocytopenia, acute renal failure and injury of the renal microvascular endothelium. In HUS the condition of proteolytic kallikrein-kinin system is unknown. The renal KKS seems to participate in the regulation of blood pressure, control of sodium and water excretion, renal vascular resistance and renin release. In this study the role kallikrein in the developing HUS was studied. The general activity of kallikrein in plasma and urine was determined by trypsin-like peptidohydrolase activity (TP), which was measured using substrate Z-D-Ala-Leu-Arg-pNa. Chymotrypsin-like protease activity (ChP) was measured using substrate Glp-Ala-Ala-Leu-pNa. Clinical data were analysed on 60 pediatric patients with HUS, 29 girls and 31 boys, ranging in the age from 3 months to 11 years. TP and ChP levels were determined in different periods of HUS (anuria, diuresis beginning, polyuria, recovery) in serum and urine. In acute phase TP and ChP activities increased significantly. In diuresis recovery serum TP activity was higher, but urine TP level became normal. In dynamic serum and urine ChP levels had tendency to decrease. The present work showed that TP and ChP levels demonstrated activity of pathological renal process and condition of glomerules.

[Hemolytic uremic syndrome as a clinical manifestation of oxidative stress]. / Gemolitiko-uremicheskii sindrom kak klinicheskoe proiavlenie oksidatnogo stressa.

An examination was made of seventeen children having various stages of the hemolytic uremic syndrome: Stage 1 is the period of an expanded clinical picture of the disease, the patients' condition is grave (anuria, azotemia, severe hemolytic anemia and thrombocytopenia); Stage 2 is the period of recovery. The plasma levels of malonic dialdehyde, dienic conjugates, alpha-tocopherol at the first stage of the disease were considerably higher than the control ones, on recovery there were their reductions though their levels remained higher than the normal levels. The levels of malonic dialdehyde in the red blood cell membranes in ill children were also much higher than those in healthy donors, but at the second stage they decreased, but remained high. The activity of superoxide dismutase in the red blood cells of ill children in the acute period of the disease did not significantly differ from that of donors. At the second stage of the disease there was a significant fall in the activity of red blood cell superoxide dismutase. The activity of catalase in the red blood cells of ill children was thrice higher than in the controls; however, this index decreased during treatment and at the second stage it did not differ from that in the controls. There were no significant differences in the activity of red blood cell superoxide dismutase in donors and ill children. Mechanisms responsible for abnormal plasma and red blood cell peroxidation are considered in the hemolytic uremic syndrome. It is concluded that free radical reactions play a substantial role in the pathogenesis of this abnormality.

[Subpopulation state of T and B lymphocytes in hemolytic-uremic syndrome in children]. / Subpopuliatsionnyi sostav T- i B-limfotsitov pri gemolitiko-uremicheskom sindrome u detei.

A study was made of the quantitative characteristics of T and B lymphocytes and of their subpopulations (A-RFC; E37-RFC; auto-RFC; EAC-RFC; Ig(+)-cells) as well as of 0-lymphocytes in the peripheral blood of 20 children aged 6 to 24 months with different clinical stages of the hemolytic-uremic syndrome (oligoanuria, diuresis onset, polyuria, clinical improvement). It is concluded that all the stages of the disease are characterized by the deficiency of certain subpopulations of T cells (especially A-RFC, E37-RFC), B lymphocytes, and 0-cells. By the moment of the clinical improvement, the cellular characteristics of the immune status do not return to normal.

[Tubulo-interstitial syndrome in children with hemolytic-uremic syndrome]. / Tubulointerstitsial'nyi sindrom pri gemilitiko-uremicheskom sindrome u detei.

As many as 53 patients with the hemolyticouremic syndrome in the acute stage were examined and treated as were 29 patients in the long-term observation period (after 12-18 months). The characteristic features of the urinary syndrome in the acute and long-term observation period and the nephrobiopsy data 12-18 months after the hemolyticouremic syndrome point out that the tubulointerstitial component is of paramount importance in the impairment of the kidneys in patients with the hemolyticouremic syndrome.

[Immunocorrective therapy of pyelonephritis in children]. / Immunokorrigiruiushchaia terapiia pielonefrita u detei.

A total of 40 children who suffered from acute or chronic pyelonephritis underwent immunological treatment with polypeptide drug tactivin. There was an evidence of clinical and laboratory improvement in 82.5 per cent of treated persons, first manifest in decreased proteinuria and normalized urinary sedimentation, and then in lower levels of bacteriuria due to the developing resistance to infectious agents. In 15 per cent of tactivin-treated children leukocyturia persisted though the disease progression was hindered. In the course of the treatment no side-effects were noted. In line with the stimulation of humoral immune response and activation of the complement system, tactivin administration evoked the competence of T-lymphocytes and potentiated the development of this link of immune system. As part of combined treatment the above preparation favourably affected the disease pathogenesis in children.

[Escherichia coli with the K1 antigen isolated in pyelonephritis in children]. / Escherichia coli s antigenom K1, vydelennye pri pielonefrite u detei.

The identification of K antigens in 113 E. coli strains isolated from the urine of 62 pyelonephritis patients was carried out. 84 strains were found to possess K antigens. The presence of K antigens was revealed in strains both in the S-form (67 cultures) and in the R-form (17 cultures). Among the strains with K antigens the presence of K1 antigen was revealed in 41.7 +/- 6.5% of cases. K1 antigen was found in combination with eight groups of O antigens (01, 02, 04, 017, 018, 050, 077, 0141) and with R antigens. The above-mentioned E. coli strains were isolated from 16 patients; of these, 3 patients had chronic pyelonephritis.