PO-17 - Identification of IgG bound to plasminogen in oncologic diseases.

INTRODUCTION: The binding of plasminogen (Pg) to cell receptors and extracellular ligands facilitates its activation to plasmin, which stimulates the extracellular matrix degradation, neoangiogenesis and tumor invasion. Plasmin can also degrade IgG thereby exposing C-terminal lysine residues. Previously, we have found IgG specifically bounded to Pg in the plasma of patients with malignant tumors. AIM: To identify IgG degraded by plasmin in the plasma of cancer patients. MATERIALS AND METHODS: Methods of ELISA were used for comparative research of levels of IgG bound to Pg in plasma of patients with the prostate cancer (PC, n=25) and lung cancer (LC, n=17). Plasma of healthy donors (n=29) was used as control. All patients signed informed consent for participation in this study. Affinity chromatography on Pg-sepharose was used for the quantification of IgG. Carboxypeptidase was used for remove of C-terminal lysine residues of the IgG. The program ATTESTAT was used for nonparametric analysis. RESULTS: The frequency of occurence of elevated levels of IgG to Pg in plasma was detected in 68% of patients with PC, 59% of patients with LC and only 12% of healthy women and 10% of healthy men. The quantification of antibodies in plasma samples showed that the quantity of IgG to Pg in patients with PC was 27% from the total amount of IgG and in healthy men - 9%. Treatment of diluted plasma samples with carboxypeptidase B abolished the elevated levels of IgG to Pg, as well as the specific activity of the purified IgG to Pg-sepharose. CONCLUSIONS: C-terminal lysine residues which are formed as a result of degradation of native IgG with plasmin can bind to lysine binding sites on the kringle domains of Pg. Increased levels of these degraded IgG can be marker at cancer.

[ANCA-associated vasculitis affecting lungs and kidneys: clinical and morphological characteristic, treatment, outcomes].

Up to 80% of all cases of pulmonary-renal syndrome are due to systemic vasculitis associated with antibodies to neutrophil cytoplasm (ANCA). Most patients die within the first year after the onset of the disease but adequate immunosuppressive therapy ensures the 5-year survival rate of 65-75%. We obtained clinical and morphological data for 34 patients with ANCA-associated vasculitis affecting lungs and kidneys treated at S. P. Botkin Hospital in 1994-2012. 16 patients presented with granulomatous polyangiitis (Wegener 's granulomatosis), 11 with microscopic polyangiitis, and 7 with eosinophilicpolyangiitis (Churg-Strauss syndrome). We made the definitive diagnosis in 79% of the cases. Pulmonary lesions were largely in the form offocal, nodular and infiltrative changes, one third of the patients suffered blood spitting/pulmonary hemorrhage and 15% respiratory distress. Most patients had renal dysfunction (16% required emergency hemodialysis), lesions of ENT skin, joints, peripheral nervous system, and eyes. Therapy with corticosteroids and cytostatics increased the total and renal survival rate up to 91 and 82% respectively despite unfavourable prognostic factors in most patients. Duration of observation was 32.5 [0.1;129] months, the survival rate depended on the severity of lung lesions whereas renal problems had no appreciable effect on life prognosis.

[Dynamics of laboratory markers of endothelial dysfunction during treatment of unstable angina].

This study was aimed to assess the diagnostic value of laboratory markers of endothelial lesions in patients with unstable angina (UA). Plasma levels of CRP, homocysteine, endothelin-1 (ET1), and pregnancy-associated plasma protein (pAPP-A) were measured by an ultrasensitive method in 51 patients. They were followed up for 4 months to evaluate the clinical picture of CHD and dynamics of laboratory parameters. The hospitalized patients with UA had elevated baseline levels of CRP (5.02+-3.35 mg/ml) during the entire study period. PAPP-A and homocysteine levels were significantly decreased (p<0.05 and p<0.0 respectively). Patients with deteriorated clinical picture of CHD had significantly elevated ET1 levels (p<0.05) both on day 1 and 4 months later It is concluded that ET1 levels increase in patients with UA and severe prognostically unfavourable CHD.

[Diagnostics of cavitary processes in the lungs].

The paper concerns CT-semiotics of cavitary processes in the lungs. Their major forms are discussed with reference to underlying pathological changes. The most common manifestations of the diseases associated with the cavitary processes are described. CT is a highly informative method for the visualization of pulmonary cavitation and the surrounding chest structures; this method improves diagnostics of pulmonary pathology.

[Blood microcirculation disorder in patients with bronchopulmonary diseases and methods of microcirculation study].

AIM: To investigate microhemocirculation in patients with bronchopulmonary pathology with application of Doppler flowmetry (DFM). MATERIAL AND METHODS: Videobronchoscopy (Olimpas or Pentax devices) was performed in 203 patients with bronchitis of different inflammation intensity: Functional activity of microhemocirculation in bronchial mucosa was studied with endobronchial laser Doppler flowmetry (LDF) which was also made in 20 healthy controls. RESULTS: LDF-grams demonstrated that patients with chronic bronchitis and pneumonia have congestive regional microcirculation with low activity of components of microcirculatory bed, venous blood congestion, weak blood flow and tissue ischemia. High informative value of the method and its availability was shown by comparison of LDF-grams on treatment day 7 and 14. CONCLUSION: High informative value of LDF procedure is found in diagnosis of vascular and intravascular microcirculatory disorders in patients with bronchopulmonary pathology.

[Effect of body mass reduction on the level of adiponectin in patients with obesity and type 2 diabetes mellitus].

Patients with obesity and type 2 diabetes mellitus are known to have hypoadiponectinemia partially compensated by switching to low-caloric diet. Reduction of the body mass results in the proportional increase of the adiponectin level and decreased severity of insulin resistance.

[Potential of endovascular embolization, chemoembolization and chemoimmunoembolization based at a multidisciplinary hospital].

The paper is devoted to a topical problem of modern roentgenovascular surgery, i.e. endovascular embolization. The results of its application in S.P. Botkin City Clinical Hospital demonstrate high efficacy of this method for the arrest of hemorrhage and treatment of various diseases.

[With long-term conservative treatment of infectious endocarditis after aortic valve replacement].

This clinical study revealed peculiarities of early and late infectious endocarditis (IE) of artificial aortic valves. Possible sources of bacteremia, pathogenic agents and clinical picture of this pathology, methods of its early and differential diagnostics are described. High efficacy of combined antibiotic therapy is demonstrated in case of impracticability of surgical treatment.

[Hemodynamic efficacy of modified gelatin in patients with acute blood loss and sepsis].

The paper presents the results of a clinical trial using the new modified gelatin-based drug hemofusin to correct dyshidria in patients with blood loss and sepsis. Based on the findings, the authors provide evidence for the high clinical efficacy of this drug and the expediency of its incorporation into a complex of infusion therapy in this patient contingent.

[Diagnostics of inflammation activity in infectious endocarditis].

This work was designed to analyse dynamics of inflammation markers (C-reactive protein, TNF-alpha) and procalcitonin in 66 patients with infectious endocarditis (IE) followed up during 6 months. Comparison of clinical observations and laboratory data revealed specific trends in these parameters in patients with different clinical course of IE and at its different stages. Some of the changes are shown to be responsible for the unfavourable prognosis of IE. TNF-alpha levels are considered to be a sensitive and informative index of the patients" clinical conditions throughout the entire period of IE evolvement.

[The incidence of chronic purulent otitis media and the treatment of this pathology in Moscow].

Analysis of medical appealability of adult subjects in outpatient clinics of Moscow during the last 5 years (2003-2008) has demonstrated a tendency toward the increased incidence of ear diseases and mastoid process lesions as well as the concomitant decrease of the incidence and prevalence of chronic purulent otitis media (CPOM). Accordingly, the surgical activity in specialized otorhinolaryngological facilities has grown up to 8.9%. Treatment of chronic purulent otitis media accounts for 47.5% of this value. 26.4% of the patients presenting with CPOM undergo hearing-saving operation on the middle ear and sometimes classical radical surgery. Patients with CPOM account for 41.1% of their total number in surdological departments. Treatment by hearing-preserving surgery on the middle ear is given in surdological departments to only 13% of the patients presenting with CPOM. In the departments for urgent otorhinolaryngological aid, patients with chronic purulent otitis media constitute 4.4% of the total and 45% of them undergo sanitizing hearing-preserving surgery on the middle ear (including extensive interventions in the cases developing complications).

[Transnasal wounds of the base of the skull encountered in the practical work of the otorhinolaryngologist].

The authors describe rare clinical observations of patients suffering transnasal injuries to the base of the skull. Based on their own experience, they propose practical recommendations for the management of such cases.

[Specific features of the clincal course of infectious endocarditis in a multi-field hospital].

The clinical course of infectious endocardities (IE) was followed in 112 patients admitted to the Botkin City Hospital in 2000-2007 with reference to the age and social structure of the pathology, its clinical symptoms, results of laboratory and instrumental analysis, strategy of antibacterial therapy, and outcome of the disease. The data were compared with those obtained in the previous period (1987-1955). He study demonstrated an increased number of men with IE (up to 65%) in the recent years and an almost two-fold rise in the incidence of primary endocardities. The frequency of thromboembolic complications also increased (from 34 to 69%) involving the pulmonary artery system (24%). The same refers to the number of patients with multivalvular lesions (2, 3 or 4 heart valves) and affected right cardiac chambers (28.4%). Shortcomings at various stages of the treatment of patients with endocarditis have been revealed.

[RAPD fingerprinting of common bream Abramis brama L., roach Rutilus rutilus L., and their F1 hybrids]. / RAPD-fingerprinting leshcha ( Abramis brama L.), plotvy (Rutilus rutilus L.) i gibridov pervogo pokoleniia leshch x plotva i plotva X leshch.

The polymerase chain reaction with arbitrary primers (RAPD-PCR) was used to study and to evaluate the genetic variation in the hybrid progeny of two Cyprinidae species, common bream Abramis brama and roach Rutilus rutilus. Genetic polymorphism was studied in 20 fishes (young of the current year) obtained in four individual crosses: R. rutilus x R. rutilus (RR), A. brama x A. brama (AA), R. rutilus x A. brama (RA), and A. brama x R. rutilus (AR). Amplification spectra obtained with eight primers contained 288 fragments, 97.6% of which proved to be polymorphic. The proportion of polymorphic fragments was 75.0% in the RR progeny, 58.1% in the AA progeny, 84.9% in the AR progeny, and 77.8% in the RA progeny. Classification analysis in the space of principal components was performed with the first four components, which together accounted for 64% of the total variance of the character under study. The individual contributions of components I, II, III, and IV were 26.8, 16.8, 11.5, and 8.9%, respectively. Fishes of the two pure species and the hybrid progeny (direct and reverse hybrids together) were clearly differentiated in the space of principal components I and II. The best differentiation of the four samples (RR, AA, RA, and AR) was observed in the space of principal components II and IV. Possible causes of high genetic variation in interspecific hybrids are discussed.

[Self-similarity in variability of human heart variability at various stages of ontogenesis]. / Samopodobie variabel'nosti serdechnogo ritma cheloveka na razlichnykh étapakh ontogeneza.

We consider the potential of applying wavelet analysis to fluctuations found in physiological systems. We focus on cardiac interbeat interval time series (RR-intervals) from a group of young adults and children and fetus heart beat rate time series (antepartum cardiotocography), because the wavelet analysis of these heart rate dynamics may provide important practical diagnostic and prognostic information not obtainable with current approaches. We show that all the signals analyzed are self-similar and propose a method for estimating this scaling feature.

[Glutamine metabolism in the brain and in the liver in critical conditions]. / Osobennosti metabolizma glutamina v golovnom mozge i pecheni pri kriticheskykh sostoianiiakh

Experiments on cats and rats have established that critical conditions caused by acute hemorrhage, hepatotoxin, and hepatectomy lead to ammonia accumulation in the brain and liver due to the predominance of decay of glutamine over its formation in these organs. With this, the depressed formation of glutamine is a universal cell response to a pathogenic agent whereas a change in glutamine deamination in disease depends on both the nature of a pathogenic agent and the organ wherein this reaction occurs.

[Evaluation of amyxin effect in prophylaxis of acute respiratory viral infections]. / Otsenka profilakticheskogo éffekta amiksina v otnoshenii ostrykh respiratornykh virusnykh infektsii.

The results of the evaluation of the oral inductor of endogenic interferon (amyxin), manufactured in Russia are presented. The use of amyxin was found to produce a drop in morbidity in acute respiratory virus infections (ARVI) among medical workers 3.4 times, i.e. the preparation exhibited a pronounced prophylactic effect with respect to ARVI. The use of the preparation was accompanied by a decrease in the number of manifest forms of ARVI. Persons given the preparation often had ARVI in a mild or asymptomatic form.