[Clinicopathogenetic characteristics of cardiorenal syndrome in non-alcoholic fatty liver disease].

AIM: To study clinicopathogenetic characteristics of cardiorenal syndrome (CRS) in non-alcoholic fatty disease of the liver (nAFDL). MATERIAL AND METHODS: Insulin resistance markers, plasma leptin and serum adiponectin concentrations. albuminuria, intima-media thickness (IMT) of the common carotid artery (CCA) were assessed in 80 patients with metabolic syndrome (60 males and 20 females, mean age 44+-11 years) and NAFDL. RESULTS: With increasing signs of affection of target organs in NAFDL there was a trend to a significant rise in detection of chronic kidney disease (CKD) and carotid artery atherosclerosis, aggravation of albuminuria and CCA IMT, lowering of glomerular filtration rate. Leptinemia was maximal in CKD patients and directly correlated with albuminuria. Patients with CCA atherosclerosis had a significant fall of serum adiponectin which negatively correlated with CCA IMT. The latter positively correlated with insulinemia, a C-peptide plasma level and HOMA index. Serum concentration of adiponectin positively correlated with DeRitis index. CONCLUSION: CRS in NAFDL is characterized with frequent development of CKD and CCA atherosclerosis defined also by unbalance of adiponectin and leptin production.

[To the problem of evaluation of public health: screening for gastroduodenal pathology on the example of atrophic gastritis in mass medical examination of the population].

Assessment of health status of the population - the most important issue in preventive medicine. The objective of this work - to determine the possibility of nonendoscopic screening for gastroduodenal pathology, by the example of atrophic gastritis, in mass medical examinations of working residents in Moscow. Minimally invasive diagnostic test system GastroPanel ("Biohit", Finland) has been used. It allows with the ELISA method to determine both serum indicators of the function of the stomach -pepsinogen 1, gastrin 17 and the presence of H. pylori infection. 758 persons have been examined. The performed study confirms the possibility with the use of a set of mentioned indicators to identify individuals suspected for the presence of gastroduodenal disorders, especially atrophic gastritis, recognized as a precancerous condition. The use in preventive medicine complex diagnostic system, firstly, will make assessment of the health of the population more correct, increase the effectiveness of preventive measures and quality of life, and secondly, will contribute to the diagnosis of diseases of the stomach and duodenum in the early stages.

[The role of leptin, adiponectin and insulin-resistance markers in development of early stages of chronic kidney disease and atherosclerosis of carotid arteries in obese patients].

AIM: To characterize clinicopathogenetically factors influencing development of early chronic kidney disease (CKD) and impairment of other target organs in obese patients. MATERIAL AND METHODS: The examination of 86 obese patients (64 males and 22 females, mean age 44 +/- 11 years) included standard clinical tests, test for albuminuria, calculation of glomerular filtration rate (GFR) by MDRD formula, ultrasound investigation of the carotid arteries to detect atherosclerotic lesion of the carotid arteries, assessment of insulin resistance - IR (plasma concentration of insulin before meal and blood C-peptide, HOMA-index), test for plasma adipokinins (leptin, adiponectin). RESULTS: Significant direct correlations were found between blood plasma leptin concentration, body mass index (BMI), plasma concentration of insulin and C-peptide, HOMA index, adiponectinemia and albuminuria. CKD patients have significantly higher than patients free of CKD levels of IR markers, waist circumference, BMI, leptinemia (38.2 +/- 28.8 and 21.6 +/- 19.8 ng/ml, respectively; p < 0.01). Obstructive sleep apnea syndrome was associated with higher IR and albuminuria, significantly lower estimated GFR (81 +/- 2 and 95 +/- 2 ml/min/1.73 m2, respectively; p < 0.05). Ultrasound evidence for atherosclerotic lesions of the carotid arteries was associated with a significant increase in blood plasma concentration of C-peptide, reduction of adiponectinemia (14.9 +/- 10.8 and 32.5 +/- 22.5 mcg/ml; p < 0.01), a rise in proportion fasting insulinemia/adiponectinemia (1.6 +/- 1.2 and 0.6 +/- 0.8, respectively; p < 0.05) and reduction of estimated GFR (86 +/- 19 and 102 +/- 25 ml/min/1.73 m2, respectively; p = 0.001). CONCLUSION: In obesity, CKD at early stages develops in parallel with atherosclerotic lesion of the carotid arteries, which correlates with progression of leptinemia, IR and attenuation of organ-protecting properties of adiponectin.

[Epidemiological characteristics of Helicobacter pylori infection in Moscow].

The authors studied the prevalence and a number of epidemiological features of Helicobacter pylori (Hp) infection in Moscow. A prophylactic medical examination revealed the infection in 863 working residents of the megapolis. A mini-invasive study was used. Enzyme immunoassay was carried out to determine serum IgG antibodies against Hp. The authors' questionnaire was used in 634 interviews. There was an extremely high incidence (88%) of Hp infection. The prevalence of the infection was found to be related to age, social status (social position, educational level), living conditions (shared or hostel habitation, no sewerage system), contact with waste waters. No association was found between the rate of the infection and the examinees' gender, the intake of raw Moscow tap drinking water, and the contact with domestic animals. Moscow was rated among the cities with a high prevalence of Hp infection. The study revealed a number of epidemiological features of the infection in the megapolis, a knowledge of which is required to elaborate measures for its prophylaxis and the prevention of its associated diseases.

[Prognostic, diagnostic, and therapeutic prospects of using adiponectine as a biomarker in cardiobascular diseases].

The role of adipose tissue as an important endocrine organ is today beyond doubt. The adipose tissue is known to be a source of many biologically active substances, adipocitokines, one of them being the adiponectine possessing anti-inflammatory, antiatherogenic and cardioprotective properties; it is believed to be one of prospective biomarkers for risk assessment, for diagnostics and, possibly, for therapy of cardiovascular diseases.

[2. Diagnostic resources and clinical indications]. / Soobshchenie 2. Diagnosticheskie vozmozhnosti i klinicheskie pokazaniia.

Preliminary investigations, dedicated to the diagnostic application of three-dimension ultrasonic angioreconstruction, confirmed the feasibility of using the above method in ophthalmologic practice in cases of suspected intraocular and orbital neoplasms. 32 patients (37 eyes) with various pathologies of the eye and orbital cavity, including choroidal melanoma, facial angiomatosis, retinal detachment, chronic uveitis etc.) were examined. The results are indicative of that the three-dimension ultrasonic angioreconstruction makes it possible to detect the latent vascular neoplasms, which cannot be defined by the standard visual and ultrasonic examinations, and the dislocation of structural elements of the eyeball tunics. Besides, it provides for evaluating their special localization and their interrelations with the neighboring anatomic elements.

[Toxic lesions of the organ of vision caused by chloroquine derivatives]. / Toksicheskoe porazhenie organa zreniia proizvodnymi khlorokhina.

An analysis of complications resulting from a long-term administration of chloroquinine derivatives is presented in the paper. The efficacy of chloroquinine derivatives for patients with rheumatological and dermatological pathologies was demonstrated. However, the remote results showed, after the administration of the above preparations, highly serious complications in different organs and primarily in the organ of vision. As for our practice, complications of various severity degrees were found in 6 patients with rheumatoid arthritis, who received the preparations in question, such complications were classified as highly severe in 1 patient. Taking into consideration that the chloroquinine derivatives have been widely used, while many doctors are not aware of the complications caused by them. We found it advisable to compile a literature survey and to enlarge it with our own observations. Eventually, we concluded that the pathogenesis of disorders in visual functions could be explained by a toxic effect produced by the chloroquinine derivatives not only on the retina but also on the optic nerve and chiasm. Our opinion is that a thorough and differentiated approach is needed to patients with the mentioned pathologies while using the chloroquinine derivatives for treatment.

[Use of endothelial protector Softel in surgery of the anterior eye segment]. / Primenenie protektora éndoteliia "Softel'" v khirurgii perednego otdela glaza.

Endothelium protector SOFTEL is developed by Ekran firm and Institute of Eye Diseases, Russian Academy of Medical Sciences. The drug was used in 157 patients aged 28-79 years. Perforating keratoplasty for corneal leukoma and keratoconus was carried out in 46 patients, cataract extraction with implantation of intraocular lens (IOL) in 94, and cataract extraction without IOL implantation in 17 patients. Two patients developed slight hypertension in the postoperative period, which resolved within 24 h, and four patients developed moderate corneal edema persisting for 1-2 days postoperation. The protective effect of softel is compatible with that of its foreign analog Healon. The drug is effective in cataract extractions with IOL implantation and perforating keratoplasty.

[Derivatives of 4-phenylpiperidine as substrates of rat brain monoamine oxidase]. / Proizvodnye 4-fenilpiperidina--substraty monoaminoksidazy mozga krysy.

A rate of utilization of 4-phenyl piperidine and its 12 derivatives by brain monoamine oxidase (MAO) was studied as compared with typical neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). The enzyme was isolated from P2 synaptosomal fraction of brain corpus striatum of Sprague-Dawley rats. 10 drugs were oxidized in the MAO-catalyzed reaction with the rate close or similar to the MPTP oxidation while 6 of them exhibited the neurotoxic effect. Analysis of MAO inhibition, using 1 microM of chlorgyline and/or deprenyl, enabled to evaluate the contribution of MAO-A and MAO-B forms to utilization of 1 mM content of the substances studied. MAO-B was shown to oxidize preferably the drugs radicals of which were substituted at 3rd position of the piperidine ring, while MAO-A preferred the derivatives with radical substitution at 4th position. The rate of substrate oxidation was decreased distinctly after introduction of complete substituents into the 3rd and 4th positions of the nitrogenous heterocycle; at the same time, presence of cyclic fluorine-containing structures increased the rate of utilization, similar to that of MPTP oxidation. Derivatives of 4-phenyl piperidine, which contained in a number of drugs, were oxidized in the MAO-catalyzed reactions and might exhibit direct- or side-neurotoxic effects.

[State of the cornea after early surgery of congenital cataract with subsequent contact correction]. / Sostoianie rogovitsy posle rannei khirurgii vrozhdennykh katarakt s posleduiushchei kontaktnoi korrektsiei.

Eighteen cases (28 eyes) with congenital cataracts are analyzed. Transciliary lensectomy technique was used for cataract extraction (the ages of the infants at the moment of surgery varied from 3.5 to 16 months), aphakia was corrected by highly hydrophilic soft contact lenses worn during the daytime. The limbic vessels, corneal epithelium, endothelium, and thickness were examined. No changes in the epithelium were revealed. Only in one case a trend to a moderate dilatation of a limbic vessel in the upper segment was seen in the presence of microphthalmia. Analysis of endothelial morphometry data has revealed a universal tendency in all the cases: cell square increased and their density reduced (by 45 and 19%, respectively) immediately after surgery. Wearing of contact lenses was associated with a somewhat rise of the cell count, this count persisting below the norm by 10% on an average. Corneal thickness increased by 0.05 mm after surgery and by 0.03 mm during lens correction.

[Kinetic characteristics of monoamine oxidase in brain regions of animals with varying degrees of sensitivity to 1-methyl, 4-phenyl, 1,2,3,6- tetrahydropyridine]. / Kineticheskie kharkteristiki monoaminoksidazy v otdelakh mozga zhivotnykh s raznoi stepen'iu chuvstvitel'nosti k 1-metil, 4-fenil, 1,2,3,6-tetragidropiridinu.

Kinetic parameters of monoamine oxidase (MAO) were studied in synaptosomal fraction P2 of brain compartments obtained from mice, rats, rabbits, cats, dogs, guinea pigs, macaque rhesus, green and javanese macaques using I-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) as a substrate. Rates of MAO-catalyzed reactions were also studied in animals sensitive to the dopaminergic neurotoxin. At low concentrations of MPTR (about 1-5 mM) the rate of MAO reaction corresponded to the index Vmax/Km. Among the animals studied the highest values of the index were found in guinea pigs and macaque rhesus, the lowest values -- in rabbits. Value of the Vmax/Km index correlated with neurosensitivity to MPTP in neuromelanin-positive and neuromelanin-negative animal groups. The biochemical index for estimation of MAO-catalyzed reactions rates may be used in evaluation of brain compartments neurosensitivity to the dopaminergic neurotoxin and its derivatives.

[Kinetics of immunoglobulin G transport through the multi-layer epithelial-hematic barrier of the respiratory tract]. / Kinetika transporta immunoglobulina G cherez mnogosloinyi épitelial'no-gematicheskii bar'er dykhatel'nykh putei.

A new class of drugs is now utilized for in vivo diagnoses and therapy of many widespread diseases. In these pharmacological and diagnostic preparations the active substance is conjugated with a vector which transports the drug to specific biological targets. Monoclonal antibodies are the most commonly used vectors: estimation of their permeability through multilayer and unilayer biomembranes is an important step in the analysis of efficiency of vector drugs. Experiments with Sprague-Dawley rats (mature females weighing 500 to 160 g) have demonstrated the ability of immunoglobulins G to penetrate through the respiratory epithelial-hematic barrier. Using solid phase ELISA, it was found that 5-25% of the total amount of mouse antiinsulin immunoglobulins G1 injected into the trachea under hexenal anesthesia can penetrate into the blood plasma. Accumulation of antibodies in the blood begins 4 hours and ceases 32 hours after the drug application in a dose of 400 micrograms. The kinetics of transmembrane transport is described by an S-like saturation function: C(t) = Cmax/(1+e-(at-b]. Penetration of monoclonal antibodies into the blood is accompanied by their distribution in the organs and tissues as well as by their clearance from the blood plasma. The clearance of monoclonal antibodies is characterized by a 24 hour half-life and is described by an exponential equation: C(t) = C0 x exp-kt. An algorithm for the interaction of these processes which should be taken into account during measurements of the transport of monoclonal antibodies and their complexes through biomembranes is proposed.(ABSTRACT TRUNCATED AT 250 WORDS)

[Study of the affinity characteristics of monoclonal antibodies by solid-phase immunoenzyme analysis]. / Issledovanie affinnykh kharakteristik monoklonal'nykh antitel v metode tverdofaznogo immunofermentnogo analiza.

An approach is proposed for measuring the binding constant (Kb) for monoclonal antibodies (MA) interacting with an immobilized antigen in indirect ELISA. This approach allows the measurement of optical density (A405) in the peroxidase reaction initiated by the conjugate at different concentrations (C0) of antibodies. Using the Scatchard plots, the dependence of A405/C0 = f (A405) for the whole range of MA concentrations was examined, and the tangential of the slope (tg alpha = Kb) of the linear portion of the antigen molecule was calculated. Analysis of MA affinity parameters by using this approach may find wide use in immunodiagnostic studies aimed at measuring antigen and antibody concentrations in biological fluids as well as for estimating the efficiency of vector drugs in which the diagnostic or therapeutic component is conjugated with the vector (MA or F(ab) fragment) responsible for the drug transport to target cells. The method proposed was used for testing mouse (BALB/C) monoclonal antibodies (IgG1) to pig insulin produced by various hybridomas as well as for estimating the effect on MA of pH, temperature and hydrophobization. The minimal detectable concentration (method sensitivity) was found to depend on Kb.

[Endothelium of the donor's transplant after penetrating keratoplasty]. / Endotelii transplantata donora posle skvoznoi keratoplastiki.

The results of a follow-up of changes in the transplant endothelial cells in 208 patients (209 eyes) in the periods from 1 week to 5 years after surgery helped the authors define the criteria for the choice of donor material with consideration of the endothelial status for various groups of patients. They suggest a method for differential diagnosis of tissue incompatibility reactions and infection recurrences in patients who were operated on for herpes virus keratoiridocyclitis by means of reflecting biomicroscopy of the endothelium. The minimal count of cells necessary for the transplant to remain transparent was estimated.

[Protective effect on the graft of bioprotectors of the endothelium in reconstructive surgery of the anterior eye segment]. / Zashchitnoe deistvie na transplantat bioprotektorov éndoteliia v rekonstruktivnoi khirurgii perednego otrezka glaza.

The authors analyze quantitative and qualitative changes in the transplant endothelium after keratoplasty and reconstruction of the anterior segment of the eye (altogether 209 surgeries) in various periods (1 week to 5 years) after surgery with the use of Quilonum and Chonsurid, endothelial protectors. A marked protective action of Quilonum has been noted, that has helped cut down the loss of endothelial cells by 10-12% in open keratoplasty and by 15% in reconstruction of the anterior segment of the eye. Chonsurid is characterized by an immediate protective effect, but in remote periods after surgery its action is cytotoxic.

[Secondary implantation of the anterior-chamber intraocular lenses with flexible supportive elements for correction of aphakia]. / Vtorichnaia implantatsiia perednekamernoi intraokuliarnoi linzy s gibkimi opornymi élementami dlia korrektsii afakii.

The authors have designed an anterior-chamber intraocular lens (IOL) with flexible supporting elements and examined the possibility of its application for secondary correction of aphakia. Secondary implantations of such IOLs have been performed in 25 eyes. The implantation has proved to be low-traumatic and effective: the vision acuity has been unchanged or improved in 92% of cases, the loss of endothelial cells has made up 8.5% when the Healon bioprotector has been used and 10.3% without it. Criteria have been developed for the selection of patients for secondary implantation of IOL.

[Open auto-keratoplasty and reflected-light microscopy of the endothelium]. / Skvoznaia autokeratoplastika i zerkal'naia mikroskopiia éndoteliia.

Reflecting microscopy of the endothelium is recommended for assessment of the corneal status before open autokeratoplasty and volumic keratoplasty. The density of 1000 per mm2 has been estimated as the transplantation minimum of endothelial cells. The results of autokeratoplasty have been better if the Healon viscous-elastic bioprotector has been employed. The findings of the dynamic follow-up of the endothelial cell density after surgery are presented.