[The importance of cytokine profile characteristics for evaluating the therapeutic effectiveness of monoclonal antibodies against IL-6 receptors in patients with rheumatoid arthritis].

AIM: To evaluate dynamics of cytokine profile characteristics in patients with rheumatoid arthritis (RA) treated with tocilizumab and to identify parameters that can be used to predict the effectiveness of therapy. MATERIALS AND METHODS: 42 patients (32 women) aged 43-55 (mean 50.5) years with the duration of disease 23-81 (mean 56.5 months), DAS28 6.4 (5.8-7.05). Each patient was given 6 i/v infusions of 8 mg tocilizumab/day at 4 week intervals in addition to standard therapy. Serum levels of IL-1b, IL-1Pa, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12, IL-13, IL-15, IL-17, Eotaxin, FGF-basic, G-CSF, GM-CSF, IFN-g, IP-10, MCP-1, MIP-1alpha, MIP-1b, PDGF bb, RANTES, TNF-alpha, VEGF were determined by xMAP multiplex technology. RESULTS: Good therapeutic effect in accordance with EULAR criteria was documented in 35 and satisfactory one in 7 patients; remission based on CDAI occurred in 33% of the cases. The levels of proinflammatory (IL-1b, -2, -6, -12, -15, -17, IFN-gamma, TNF-alpha) and anti-inflammatory (IL-4, -5, -9, -10, -13) cytokines, hemokines (IL-8, MCP-1, MIP-1a, MIP-1b, MIP-1b) and growth factors (IL-7, GM-CSF, VEGF, FGF basic, IP-10) dropped down by week 24 of the treatment (p < 0.05). Remission based on CDAI was associated with higher baseline levels of IL-1b, -2, GM-CSF and TNF-alpha and good outcome according to EULAR criteria with the rapid fall in IL-10 and -13 levels. CONCLUSION: Therapy with tocilizumab results in the rapid and well apparent decrease in the concentration of the practically entire spectrum of cytokines. Measurement of IL-1b, -2, -10, -13, GM-CSF and TNF-alpha may be useful for the prediction of the effectiveness of therapy of RA with tocilizumab.

The value of peritoneoscintigraphy in the investigation of ultrafiltration loss during peritoneal dialysis.

Peritoneoscintigraphy (PSG) was performed in 18 patients with ultrafiltration (UF) loss during peritoneal dialysis (PD). In 9 patients PSG was abnormal after peritonitis (PT), and transfer to hemodialysis (HD) was necessary. In three cases peritoneal catheter malfunction was suspected, and PSG provided information about the catheter's position and function. In two cases loss of UF was connected with extraperitoneal leakage of the dialysis solution (which was confirmed by PSG). In cases of UF loss and normal control, the peritoneal equilibration test (PET) was used, and its result was abnormal for glucose D/D0 (too high). PSG was useful for diagnosing the reasons for UF loss during PD.

[The duration of courses of manual therapy in vertebrogenic neurological and somatic pathology]. / Prodolzhitel'nost' kurosv manual'noi terapii vertebrogennoi nevrologicheskoi i somaticheskoi patologii.

The authors have developed and validated algorithms, programs, regimens and techniques of manual and instrumental treatment which produced positive effects in 99% of patients with neurological syndromes of spinal affections. The criteria of the treatment discontinuation were alleviation of painful syndrome by 25-50%. This occurred, as a rule, after 3-4 sessions. The course averaged 10 sessions and more. The treatment was discontinued after stabilization of subjective improvement.

[Personal experiences in the treatment of peritonitis with a complicated extended program of peritoneal dialysis]. / Doswiadczenia wlasne w leczeniu zapalenia otrzewnej wiklajacego przewlekly program dializ otrzewnowych.

In 37 pts treated with peritoneal dialysis (PD) in years 1980-1990 results of peritonitis (P) treatment were compared between years 1986-90 (cycle II) and years 1980-85 (cycle I). In I cycle 47 episodes of P occurred in 9 of 21 pts treated with PD, and in cycle II 15 episodes of P in 7 of 16 dialysed pts. Treatment of P was as follows: in cycle I, daily standard PD with gentamicin and cephradine added to 2.01 dialysing exchanges; in cycle II, after initial lavage of peritoneum with a few litres of dialysing solution, 1.0 g vancomycin was given iv and continuous PD started using 1.0 litre prolonged exchanges and aminoglycosides added to dialysis solution. Treatment protocol used in cycle II was more effective than the first one: all episodes of P were immediately cured (only 32 of 47 in cycle I), there was only 1 relapse (in cycle I 6/32 cured P), duration of P was shorter (mean 6.5 days/9.8 days in cycle I) and morphological changes of peritoneum were less expressed than in cycle I. Practically important indicator of cure was decline of polynuclear cells in smear of peritoneal effluent sediment (less than 50% of cells). All 9 pts suffering from P in cycle I had to be transferred to HD (43% of all dialysed pts) and only 2 in cycle II (12% of all dialysed pts).

[Our experience with the diagnosis of peritonitis complicating a long-term program of peritoneal dialysis]. / Doswiadczenia wlasne w rozpoznawaniu zapalenia otrzewnej wiklajacego przewlekly program dializ otrzewnowych.

Among 37 patients (pts) with irreversible renal failure treated in years 1980-1990 with chronic peritoneal dialysis there were 18 treated with continuous ambulatory peritoneal dialysis (CAPD) and 19 treated with standard intermittent peritoneal dialysis (SIPD). Mean frequency of peritonitis (P) was 1 episode per 9.0 patients-months. The important symptoms for early diagnosis of P were as follows: cloudiness of peritoneal effluent (PE) and high (more than 50%) percentage of polynuclear cells in the smear of PE sediment. Positive results of PE culture were obtained only in 50% of P episodes in years 1980-1985, mostly in pts treated with CAPD (17/21 pts). In the period of 1986-1990, in pts treated mostly with SIPD (15/16 pts), positive results were obtained in 80% of P. Improvements of bacteriological diagnosis of P, especially in pts treated with CAPD, were discussed. "Prophylactic" cultures of PE were found to be of no value.

[Evaluation of various immunologic parameters in patients treated by continuous ambulatory peritoneal dialysis (CAPD)]. / Ocena niektórych parametrów immunologicznych u chorych leczonych ciagla ambulatoryjna dializa otrzewnowa (CADO).

The authors investigated some immunologic parameters in 17 patients treated with CAPD during 11.0 +/- 6.8 months. There were no disturbances in humoral immunity. In cell-mediated immunity we observed only skin anergy specially in patients with high peritonitis rate. In this group we observed lower concentration of IgG, C3 complement and fibronectin in peritoneal effluent.

[An index to the antioxidant activity of biological materials]. / Indeks antiokislitel'noi aktivnosti biologicheskogo materiala.

A new method for measuring serum and tissue antioxidative activity is based on a relationship between accumulation of lipid peroxidation (LPO) products in incubation medium and the amount of the substrate during LPO activation. The ratio of malonic dialdehyde accumulation during LPO activation in two samples of different volumes is proposed as an index of antioxidative activity.

[The effect of verapamil on peritoneal dialysis efficiency in a clinical study]. / Wplyw verapamilu na wydajnosc dializy otrzewnowej w warunkach klinicznych.

Authors investigated influence of intraperitoneal verapamil on standard peritoneal dialysis efficiency. 18 peritoneal dialyses were performed in 4 patients. Verapamil was used in doses 5 and 10 mg per exchange of peritoneal fluid without a significant influence on ultrafiltration, sodium sieving index, urea and creatinine clearances. At the start of the study all patients had normal peritoneum evaluated with peritoneal scintigraphy using sulphide colloid, glucose equilibrium curve and D/P for creatinine.

[Effect of hemodialysis fluids with different pH values and buffer types used in peritoneal dialysis on the phagocyte system in the peritoneal cavity. The experimental part]. / Wplyw plynów dializacyjnych o róznych wartosciach pH i rodzajach buforów stosowanych w dializie otrzewnowej na uklad fagocytów jamy otrzewnowej. Czesc doswiadczalna.

In a four-hour exchange of dialysing fluid in 120 healthy mice it was checked whether and in what degree changes of the pH of the dialysing fluid in the range from 5.09 to 7.02 and change of the buffer in the dialysing fluid (acetate, lactate) have an effect on the phagocytic and bactericidal ability of the phagocytic cells in the peritoneal dialysate. The study of the count of phagocytic cells, their bactericidal ability (NBT test) and phagocytosis ability (latex test) showed that neither the type of the used buffer nor pH changes of the dialysing fluid in the range 5.09-6.18 had no effect on the defensive properties of the phagocytes in healthy peritoneal cavity. The observation of a statistically significant increase in the proportion of cells of low phagocytic ability in the group of mice receiving acetate buffer of pH 7.02 requires further studies.

[Structuro-functional characteristics of the left heart ventricle in young athletes of various specialties]. / Osobennosti strukturno-funktsional'nogo sostoianiia levogo zheludochka serdtsa u iunykh sportsmenov raznoi spetsializatsii.

The structural-functional state of the left ventricle of boys aged 8-12 years going in for middle-distance racing (the 1st group), swimming (the 2nd group) and wrestling (the 3rd group) has been studied by the method of echo-, poly- and electrocardiography. It is found that posterior wall of the ventricle myocardium is thicker, size of its anteroposterior cavity as well as cavity volume and total volume are larger, the myocardium mass is higher in younger sportsmen as compared with non-sportsmen of the same age. These data indicate the development of ventricular hyperfunction in both isometric and isotonic regimes. In trained pupils the heart rate is lower, all the phases of total systole are longer, intrasystolic value is smaller, and myocardium tension index is higher. They are the indicators of economy development in ventricular activity. These differences are the most significant in children developing their endurance.

[Ultrasonic changes in organs in the course of poisoning with mushrooms]. / Ultrasonograficzny obraz zmian narzadowych w przebiegu zatrucia grzybami.

A case of the poisoning with mushrooms of severe clinical course is presented. Lesions to parenchymatous organs were diagnosed with ultrasound. The authors stress the value of ultrasound examination in the evaluation of the lesions to internal organs in the course of poisoning and in prognosis.

[The cytoprotective effect of prostaglandin E2 in duodenal ulcers]. / Tsitoprotektivnoe deistvie prostaglandina E2 pri iazvennoi bolezni.

Intragastric administration of a synthetic analog of prostaglandin E2 to patients with duodenal ulcers results in depression of the gastric acid production and in reduction of potassium level, leads to an elevation of the sialic acid debit and a rise of sodium concentration, not essentially changing calcium, chlorides, and pepsin levels. A combined analysis of gastric acid production and measurements of sialic acids, sodium and potassium detect the imbalance of the mucoid and bicarbonate secretion in peptic ulcers, this helping predict the disease course.

[Effect of various types of sports on the pulmonary rheogram of young school age children]. / Vliianie raznykh vidov sporta na reogrammu legkikh detei mladshego shkol'nogo vozrasta.

The pulmonary blood circulation of boys aged from 8 to 12 going in for swimming and wrestling has been studied by the rheographic method. It is found that the pulmonary rheogram of young sportsmen differs significantly from the one of non-sportsmen of the same age. The basic wave amplitude is larger, its elevation and fall angle is smaller, presystolic, systolic and diastolic parts are longer, rheographic systolic and diastolic indices as well as vascular wall elasticity index are higher, peripheral resistance of arterioles and cappilaries are lower in trained children. These values demonstrate a decrease in the pulmonary blood flow rate and an increase in its volume as well as improvement of the elastic-viscid properties of blood vessel walls. They also indicate the economy development of pulmonary circulation activity. The mentioned deviations are better expressed in young swimmers.

[Status of the electrolyte balance of the gastric juice during stimulation of secretion by histamine]. / Sostoianie élektrolitnogo balansa zheludochnogo soka pri stimuliatsii sekretsii gistaminom.

The content of electrolytes (Na+, K+, Ca2+) in human basal secrete has been determined before and after injection of histamine in gastric juice and insoluble mucus in healthy people. Electrolytes in the mucous membrane of the stomach, gastric juice and insoluble mucus have been determined in dogs with stomach fistula after Basow. Species peculiarities have been marked in electrolyte content change during gastric secretion.

[In vivo effect of L-thyroxine on carbohydrate content of glycoproteins in subcellular fractions of the rat liver]. / Vliianie in vivo L-tiroksina na soderzhanie uglevodsoderzhashchikh komponentov glikoproteidov v subkletochnykh fraktsiiakh pecheni u krys.

Effect of various doses of L-thyroxin on content of some carbohydrates (sialic acids, hexosamines, hexoses bound with proteins and L-fucose) in glycoproteins was studied in rat liver subcellular fractions. Content of these carbohydrates was altered similarly in liver tissue, whereas various doses of the hormone caused different changes of the glycoprotein components in liver tissue subcellular fractions. Within 24 days after L-thyroxin administration small doses of the hormone led to elevation of these carbohydrates in mitochondria and microsomes, while their content was unaltered in biomembranes, intermediate doses caused a decrease of the carbohydrates in mitochondria and microsomes and an increase in plasmatic mitochondrial and microsomal membranes, high doses of L-thyroxin caused a decrease of the carbohydrates in all the structures studied. Duration of normalization of the glycoprotein carbohydrate components in rat liver tissue depended on the L-thyroxin dose administered.