[Evaluation of the placental morphofunctional state in perinatal HIV transmission].

The paper presents the results of investigating the mechanisms of placental insufficiency and transplacental infection of infants born to HIV-infected mothers who have received specific antiretroviral therapy mothers and who have not.

[Cells of immune system of mother and trophoblast cells: constructive cooperation for the sake of achievement of the joint purpose].

In the present review modern data about change of morfo-functional properties of a trophoblast during pregnancy, and also about influence of the cytokines produced by cells of a microenvironment, including leucocytes of mother, on a functional state of trophoblast is cited. Features of interaction between trophoblast and immune cells of mother are described within physiological pregnancy and within pregnancy complicated by preeclampsia.

[Morphological features of placenta and expression of collagen-6, MMP-1 and TIMP-1 in placental membranes of women with premature rupture of membranes].

Morphological and immunohistochemical investigation of the women's afterbirth with premature rupture of membranes (PROM) and well-time ruptures of placental membranes has been carried out. Inflammatory infiltration of membranes and placental deficiency were higher at patients with PROM. The absence of inflammatory changes in placental tissue during growth of anhydrous gap was demonstrated. The optical density and square of MMP-1 expression were higher and TIMP-1 was lower in membranes of PROM-group than in the control one. No significant changes were found in expression of collagen-6.

[Neuroimmunoendocrine mechanisms of regulation of reproductive function].

Modern molecular biological studies have significantly improved understanding of structural and functional organization of the female reproductive system. The paper gives a brief overview of the literature and own research on verification and expression in the endometrium and placenta of many peptides, biogenic amines, steroids, cytokines and other signalling molecules, which, acting as hormones, enzymes, inhibitors, receptors, growth factors, immunoregulatory agents, transport's and binding proteins, provide the local regulation of intercellular neuroimmunoendocrine relationships that play a key role in the mechanisms of human embryogenesis and reproduction.

[Detection of endothelial NO synthase in the placenta and nitric oxide in the serum of pregnant women in the complex evaluation of the efficiency of treatment for gestosis].

The content of nitric oxide (NO) in the blood and that of endothelial NO synthase in different placental structures were studied in 107 women with impaired fetoplacental blood flow. The change in the concentration of these substances was established to reflect the efficiency of using this or that treatment mode of gestosis.

[Placental changes in type 1 diabetes mellitus].

Pathological immune complexes (PIC) are revealed in high percent (100%) of cases by placental immunomorphological studies in insulin-dependent tissue. This leads to the development of an immunopathological process in the placental tissue. Parallel electron microscopy shows that some placental vessels are in close contact with the basal membrane of syncytiotrophoblast. PIC deposition in the area of confluence of the basal membranes of a syncytiotrophoblast and the vascular endothelium, which act as filters, results in the destruction of the basal membranes to rupture formation, causing the transplacental transport of substances together with immune complexes in the form of endocytotic vacuoles from the intervillous lacuna directly to the vessel. Active proliferation of vascular endotheliocyes leads to typical angiopathy as the body's defense reaction.

[Algorithm of examination and treatment of women with mixed urine incontinence].

The examination including filling cystometry, urethral profilometry, uroflowmetry, perineal ultrasonography was made in 62 females aged from 29 to 66 years with a clinical diagnosis of mixed urine incontinence (MUI). Irrespective of the verified diagnosis, the treatment started with conservative methods. Surgical intervention was performed if moderate and severe MUI persisted after conservative therapy. The diagnosis of MUI was confirmed in 66.1% examinees. Stress urine incontinence and hyperactive urinary bladder were diagnosed in 9.7 and 24.2% cases, respectively. The conservative treatment resulted in disappearance of the symptoms of MUI in 43.9%, in partial response in 34.1% patients. 22% patients were treated surgically. Urodynamic and ultrasonic indices helping choice of surgical policy in MUI were not determined. Thus, the principle of staged and comparative assessment of clinical, urodynamic and ultrasound findings improves diagnosis of MUI. Pathogenetic conservative treatment, as the first stage of MUI therapy, provides indications for surgery.

[Analysis of the polymorphic alleles of genes encoding phase 1 and phase 2 detoxication enzymes in patients with endometriosis]. / Analiz polimorfnykh allelei genov, kodiruiushchikh fermenty 1-i i 2-i fazy detoksikatsii, u bol'nykh éndometriozom.

Polymorphysms of the three genes encoding phase 1 (CYP1A1, mEPH1, and CYP2E2) and the three genes encoding phase 2 (NAT2, GSTM1, and GSTT1) xenobiotic detoxication enzymes were typed by use of PCR in 74 patients with extragenital endometriosis. Distribution of the CYP1A1, mEPHX1, CYP2E1, NAT2, and GSTM1 polymorphic alleles in the patient group corresponded to that in the control group. At the same time, functionally defective genotypes GSTM1 0/0, NAT2 S/S; GSTM1 0/0, GSTT1 0/0; and GSTT1 0/0, NAT2 S/S were three, four and eight times more frequent among the patients than in healthy individuals. This observation suggests the existence of a distinct association between the functionally defective alleles of the phase 2 xenobiotic detoxication and endometriosis. Possible mechanisms underlying this association are discussed. It is suggested that typing of the NAT2, GSTM1, and GSTT1 genes can be useful for the assessment of the predisposition to endometriosis.

[Diagnosis of short-term subclinical shifts in the level of humoral parameters]. / Diagnostika kratkovremennykh subklinicheskikh sdvigov urovnia gumoral'nykh pokazatelei.

Algorithm of evaluating the blood humoral parameters has been theoretically and experimentally validated and clinically tried with due consideration for the circaseptan fluctuations in their levels. Probability of deviations from the normal range of values depends on the number of measurements making use of the suggested algorithm.

Circulating bufodienolide and cardenolide sodium pump inhibitors in preeclampsia.

OBJECTIVE: To determine plasma levels of the endogenous bufodienolide Na+/K+ ATPase inhibitor, marinobufagenin-like factor (MBG), in normotensive pregnancy and in preeclampsia, to compare changes of MBG with that of ouabain-like compound (OLC), and to characterize the purified MBG immunoreactive factor from preeclamptic plasma. DESIGN AND METHODS: Consecutive sample study. The levels of MBG and OLC compounds were measured in extracted plasma by solid phase fluoroimmunoassays. MBG and ouabain immunoreactive materials were partially purified from preeclamptic plasma via reverse-phase high-performance liquid chromatography (HPLC) and studied for their ability to cross react with MBG and ouabain antibodies, and to inhibit the Na+/K+ ATPase from human mesenteric arteries. Vasoconstrictor effect of authentic MBG was studied in isolated rings of human umbilical arteries. RESULTS: In 11 nonpregnant control individuals, plasma concentrations of MBG and OLC were 0.190+/-0.04 nmol/l and 0.297+/-0.037 nmol/l, respectively. In the third trimester of noncomplicated pregnancy (n = 6), plasma MBG increased (0.625+/-0.067 nmol/l, P<0.05), and OLC did not (0.32+/-0.07 nmol/l). In 15 patients with preeclampsia, plasma levels of both MBG and OLC increased dramatically (2.63+/-0.10 nmol/l and 0.697+/-0.16 nmol/l, respectively, P<0.01 versus both control groups). When fractionated by reverse phase HPLC, OLC was eluted by 18% acetonitrile, and MBG by 48% acetonitrile. Serially diluted samples of MBG and OLC immunoreactive materials from HPLC fractions reacted with MBG and ouabain antibody in solid phase immunoassay in a concentration dependent fashion. Authentic MBG caused contractile responses of isolated rings of human mesenteric arteries in a concentration-dependent manner. Similarly to the authentic MBG, HPLC purified MBG immunoreactive material from preeclamptic plasma inhibited Na+/K+ ATPase purified from human mesenteric artery. CONCLUSIONS: Our observations demonstrate the coexistence of two endogenous cardiotonic steroids in preeclamptic plasma, a more polar OLC and a less polar MBG-like compound. Substantial increases in plasma OLC and MBG immunoreactivity in preeclampsia, along with the vasoconstrictor properties of authentic MBG and Na+,K+ ATPase inhibitory activity of human MBG immunoreactive factor, suggest, that in preeclampsia, plasma concentrations of MBG are enough to substantially inhibit the sodium pump in cardiovascular tissues, and are in accordance with the views attributing endogenous digitalis-like factors a pathogenic role in the preeclamptic hypertension.

[Electron microscopic and immunomorphologic study of the placenta in genital mycoplasmosis]. / Elektronno-mikroskopicheskoe i immunomorfologicheskoe issledovanie platsenty pri genital'nom mikoplazmoze.

Peculiar ultrastructural features allowed the authors to reveal M. Homminis corpuscles in placental tissues of women with genital mycoplasmosis. Mycoplasma was found in the amniotic epithelium, chorionic plate, in the lumen of villous capillaries, this showing possible hematogenic way of the infection from mother to fetus. In the placenta of women with genital mycoplasmosis immunopathological processes develop in association with formation of pathogenic immune complexes (PIC) that are fixing the C3 complement fraction. Location of PIC on the syncytiotrophoblast membranes and vascular endothelium causes immunological inflammation with the involvement of immunocompetent cells resulting in the destruction of syncytial membranes and membranes of the placental barrier. Damage to the placental barrier membranes promotes the development of placental failure, a complicated course of pregnancy and delivery, deterioration of the state of the fetus and newborn infant.

[Comparison of the tocolytic and hemodynamic effects of calcium channel blockers in pregnant rats]. / Sravnenie tokoliticheskogo i gemodinamicheskikh éffektov blokatorov kal'tsievykh kanalov u beremennykh krys.

It was demonstrated in experiments on pregnant rats that toxolytic doses of the calcium channel blockers nifedipine, cardiazem (diltiazem) and verapamyl reduce blood pressure, heart rate, and doppler ultrasound velocity in the uterine artery. Toxolytic doses of sensit (fendilin) do not change hemodynamics in pregnant rats.

[Disruption of central regulation of reproductive function under the effect of unfavorable environmental factors]. / Narushenie tsentral'noi reguliatsii reproduktivnoi funktsii pod vliianiem neblagopriiatnykh faktorov vneshnei sredy.

Rat experiments have established that early unfavourable environmental influences cause a non-specific response of the central link of reproductive function regulation as manifested by the impaired circadian rhythm of gonado releasing hormone through the vascular organ of the lamina terminalis. It is suggested that this is induced by changes in prolactin production. Under unfavourable environmental influences there were insidious changes in the neuroendocrine regulation of reproductive function, which emerge with the involvement of additional damaging factors or functional tests. They are easily reversible and functional, but they may be regarded as the first signs of reproductive dysfunction.

[Clinico-neurological and encephalographic aspects of toxicosis in late pregnancy]. / Kliniko-nevrologicheskie i entsefalograficheskie aspekty pozdnego toksikoza beremennykh.

Clinico-neurologic and electroencephalographic (EEG) examinations of 149 women suffering from late gestosis, carried out during pregnancy and after labor, have revealed various neurologic syndromes (vegetovascular dystonia, narcoleptic and neuroendocrine syndromes, pyramidal insufficiency syndrome) in all of them; these syndromes correlated with the severity of late gestosis and EEG changes. The detected changes indicated the presence of the hypothalamic syndrome in women suffering from late gestosis, this syndrome being more marked in grave forms of gestosis. The detected neurologic symptoms and EEG changes persisted long after delivery (up to 7 years). The authors emphasize the necessity of timely adequate therapy of women suffering from gestosis, that should include tranquilizers, anticonvulsants, vasoactive and nootropic drugs.