Изв. Нац. академии наук Беларуси. Сер. мед. наук, 2004, No.2
/ Издания академии / Научные журналы
Изв. Нац. академии наук Беларуси. Сер. мед. наук, 2004, No.2
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Известия Национальной академии наук Беларуси
СЕРИЯ МЕДИЦИНСКИХ НАУКИздатель Беларуская навука, Минск, Республика Беларусь |
Номер 2, 2004
СОДЕРЖАНИЕ
КЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНА
Demidchik Yu. Ye., Demidchik Ye. P., Gedrevich Z. E., Cherstvoy Ye. D., Fridman M. V., Zhilko A. A., Kiselev P. G., Nerovnaya A. M., Kolobuhov A. E., Kondratovich V. A., Lyakhovskiy V. V.
Follow up treatment results of patients with operable thyroid medullary carcinoma. pp. 5--12
Summary: The retrospective analysis has been carried out of follow up treatment of patients with thyroid medullary carcinoma. In 168 patients (123 female, 45 male) at the age from 12 up to 77 yers old genetically determined kinds of the disease have been diagnosed in 9 (5.4%) patients. For all patients has been performed radical surgery. For 100 patients (59.5%) post operative irradiation or polychemotherapy have been applied. The mean observation period for the patients constituted 53.3 months. Within this period progressive tumor has been diagnosed in 49.2% of observations. 33 patients (19.6%) have died. Survival rate of 5, 10 and 15 years constituted 79.7%, 61.2% and 52.5%, respectively. While evaluating survival rate the following unfavorable prognostic factors have been established: male, age more than 60, long-lasting anamnesis, negative tumor capsule status, extrathyroidal growth, metastatic lymph nodes , large tumor size. Administration of adjuvant radiation therapy did not resulted in recurrent tumor risk decrease. A high disease recurrence rate (23.8%) after radical surgical operation does not give rise to doubts that for this kind of carcinoma in all cases total thyreoidectomy with bilateral neck dissection is necessary.
Zmatchinski V. A., Uss A. L., Milanovich N. F., Dzuba E. V., Morozova O. M., Solovieva N. S.
Blood stem cell harvesting and hematopoietic recovery after high dose chemotherapy in patients with Hodgkin's lymphoma. pp. 13--16
Summary: We performed 128 peripheral stem cell collections on 62 patients with Hodgkin's lymphoma. The most effective regime of stem cell mobilization was DHAP+G-CSF. Stage of disease, histological variant and number of previous courses of chemotherapy didn't influence on mobilization of CD34 cells. After high dose chemotherapy (BEAM or accelerated BEAM) patients received more than 5• 106 CD34 cells/kg recover more rapidly than those receiving 2-5• 106 CD34cells/kg. Administration of G-CSF or GM-CSF after high dose chemotherapy didn't accelerate the leukocytes recovery in patients receiving more than 10• 106 CD34 cells/kg.
Beloenko E. D., Nikolaev V. I., Pinchuk L. S.
Modern trends of joint endoprostheses development. pp. 17--23
Summary: Tribological mechanisms of the endoprosthesis operation in vivo are examined as opposed to the natural joint functioning. It is asserted that the traditional designes of artificial joints embody the ideas advanced in the 1960's by J. Charnley and resemble machine members that are insufficiently adapted for operation in human organisms. The authors put forward a concept on simulation of biophysical functions of the bone and cartilage tissue and the bioelectrical potentials of natural joints in joint endoprostheses. Information is given on developed by the present authors artificial cartilage based on high molecular weight polyethylene; its structural, physico-mechanical, tribological and medico-biological characteristics are expounded. Experimental evidences obtained in the course of investigations visualize that synovia exhibit the thcrmostimulated current spectra without any electrical treatment. A principal way of improving joint endoprosthesis lubrication via constant electric (electrets) end magnetic fields is justified. A forecast of contemporary trends in joint endoprosthesis is set forth.
Shishkova M. K., Semenenya I. N., Ponomarev V. V., Kuzub N. V.
Thyroid hormone content in blood serum in patients with central subfebrility. pp. 24--25
Summary: Results of study of thyroid hormone content in blood serum in patients with central subfebrility are presented in this paper. Decrease in T3 and T4 levels in blood serum was discovered, which can be a thermoregulatory response to lower the body temperature and recover temperature homeostasis.
Bychkov A. V., Semenenya I. N., Serdyuchenko N. S., Barsukov A. N.
Duration of postoperative hospital treatment of patients after emergency Caesarean sections depending on the operation time in day and night cycle. pp. 26--29
Beloenko E. D., Kandybo I. V., Zarovskaya A. V., Khudnitsky S. I.
Characteristic of regional hemodynamics in cases of extremities' bone fractures in condition of immobilization. pp. 30--35
Summary: There have been conducted studies of peculiarities of regional blood circulation in cases of cms fractures. The methods of treatment of plates and screws and skeletal stretching were implemented. 34 patients were examined using Impedance Rheography and Color Duplex Sonography. The test group consisted of 20 healthy volunteers.
It has been revealed that fractures of the tibial's diaphysis were accompanied by general reaction of altered rest tonus and vasomotor reactivity of both the injured lower extremity and healthy one. Noninvasive research methods have proved that treatment of fractures using the treatment of plates and screws allowed to reduce time of imposed immobilization. Such treatment also allowed for earlier activization of proprioceptive afferentation. As a result, there occured the faster restoration of interaction between central and local mechanisms that regulate regional blood circulation.
Baranovsky A. E.
Hyperbaric oxygenation in correcting neurological lesions during postoperative period in oatients with olfactory meningiomas. pp. 36--39
Summary: In this paper the results of application of hyperbaric oxygenation (HBO) in the early postoperative period on patients who had the operation for removing the meningiomas of the olfactory area are presented.
The effectiveness of the applied method is shown as addition to the routine therapy (61.5% -- of excellent and good results aminng patients who received a course of HBO against 30% without HBO). Application of HBO in the early postoperative period allows to lessen the time of patients' staying in a hospital as well as to cut down on the temporary disability aminng the presented group of patients.
Smeyanovich A. F., Shanko Y. G., Golovko A. M.
Peculiarities of surgical treatment of parastemal meningiomas in petroclival region. pp. 40--45
Summary: The analysis of 19 clinical observations of petroclival meningiomas is presented. 15 (78.9%) patients were operated by the suboceipital approach. Subtotal removal of meningioma was made in 7 (46.7%) cases, partial -- in 6 (40.0%), and in 2 (13.4%) cases only decompression of the brain stem was made. 4 (21.1%) patients with mainly supratentorial spreading of tumor were operated by subtemporal transtentorial approach (partial removal of tumor was made in those cases). As the result of vertebral artery and its perforating branches encasement it was impossible to make a total removal of meningiomas. Postoperative mortality accounted for 21.1% (4 cases). The stable late postoperative neurological disorders were noticed in 11 cases (73.3%) out of all survived patients, which constitutes 57.9% of the total amount of people operated. One of the ways to solve the petroclival meningiomas surgical problems is to diagnose the disease in time.
Sidorenko V. N.
Peculiarities of reactivity of isolated placental vessels in case of gestosis. pp. 46--51
Summary: In case of gestosis, constrictive reactions of smooth-muscular cells of placental vessels are reduced under the exposure of vasoconstrictors (serotonine and hydrogen peroxide). This phenomenon is accompanied by activation of vasoactivc effects of cndothelium resulting in intensification of constrictive reactions agtoinst histamine, in normalization of constrictive effects of serotonine and in promotion of sensibility of placental vessels agtoinst hydrogen peroxide exposure. One should assume that genesis of gestoses is connected with the disorders in remodulation, and as a result, in reactivity of placental vessels agtoinst vasoconstrictive agent and it leads to the reduction of uterinc-placental perfusion and to the development of nidul ischemia of placenta.
Tkachev S. V., Ushkov A. A., Polovinkin L. V.
Dynamics of development of oxidative stress by influence of copper containing xenobiotics. pp. 52--58
Summary: Single injection of copper containing xenobiotics into a stomach in subtoxic doses causes the intensic accumulation of protein and lipid products in liver and serum and the complex dynamics of changes of enzyme and non-enzyme components of antioxidantive system. During increasing of oxidative stress the different changes of concentration of low molecular thiol antioxidants and activity of enzymes of recycling of glutathione are observed.
Lelevich S. V.
Characterictics of glycolysis in the rat liver in dynamics of chronic morphine intoxication. pp. 59--61
Summary: The effect of chronic morphine intoxication on the glycolysis in the rat liver was studied. The long-term morphine administration led to rat liver glycolysis inhibition, with the inhibition extent being dependent on the drug administration duration.
Konopelko N. F., Tsyrus T. P., Konoplya E. F., Kravchuk Z. I.
Immunochemical identity of serum ferritin in patients with gastric cancer and L-ferritin. pp. 62--67
Summary: Most malignancies generally result in increased ferritin concentration in serum. However, both increased and decreased ferritin concentrations, together with the normal ones, were previously reported in patients with gastric cancer. This diversity of results could have been explained by appearance, in gastric cancer patients, of "pathological" ferritin isoforms that might immunologically differ from normal ferritin present in healthy people.
Using in-house ELISA purposely designed to discriminate ferritin isoforms, we compared immunochemical identity of serum ferritin and recombinant L-ferritin. To analyze identity of ferritins, two formats of ELISA, the so-called dilution (linearity) test and the recovery test, were applied. The results of these two tests clearly indicate that serum ferritin present in patients with gastric cancer is immunologically identical to recombinant L-ferritin introduced in our assay system as a standard of L-type ferritins. Thus, high variability of serum ferritin levels in patients with gastric cancer might be attributed to the physiological status of the organism affected by the disease.
Kozlov I. D., Grakovich A. A., Apanasevich V. V., Zborovsky E. I., Plaschinskaya L. I.
Somatotype as an indicator of individual predisposition to ischemic heart disease. pp. 68--74
Summary: The aim of our 18-year survey, conducted in the city of Minsk is to study the prevalence of arterial hypertension (AH), hypercholesteremia (HC) and ischemic heart disease (IHD) aminng randomly selected men, aged 40--59 years, and the frequency of the development of myocardial infarction among persons of the various constitutional types.
A total of 3.832 males at the age of 40--59 years from the city of Minsk were selected at random and underwent the initial and 3 annual repeated examinations using standard methods of the examination and the classification criteria as regards ischemic heart disease, arterial hypertension and hypercholesteremia, applied in the population cardiologic investigations and supplemented by the enlarged anthropometry with the subsequent somatotyping. The registration of all cases of myocardial infarction and all cases of death from ischemic heart disease was included in the 18-year prospective survey.
It was established that the hypersthenic somatotype, determined by Pinie's index or by metric index, was accompanied by the accumulation of risk factors for IHD -- AH and HC (33.0%) as compared with the asthenic somatotype (18.0 and 16.5%, respectively). This accumulation was associated with the significantly greater prevalence of IHD in persons of the hypersthenic somatotype (19.0%), in comparison with the asthenic somatotype (7.5%) and with more frequent emergence of new cases of IHD within next 3 years of the survey (10.3 and 6.1%, respectively). Consequently, during 18 years of the survey the frequency of the development of myocardial infarction and death from IHD among persons of the hypersthenic somatotype was up 6.55 and 4.70 per 1000 man/year of the observation versus 3.81 and 3.07 in individuals of the asthenic somatotype, accordingly.
The hypersthenic somatotype in men aged 40--59 years can be considered as an indicator of the predisposition to IHD, associated with the accumulation of AH, HCh and the more frequent development of myocardial infarction and death from IHD.
Sidorenko V. N., Bulanova K. Ya., Lobanok L. M.
Correction of high aggregate capability of thrombocytcs in case of gestosis with adcphos and magnium containing remedies. pp. 75--81
Summary: Hypothetical model of gestosis progression supposes that alteration in physiological activity of thrombocytes occurs earlier than other symptoms of gestosis. That is why preventive measures must be directed towards the correction of functional state of thrombocytes and towards prevention hemostasis system from exhaustion.
One may suppose that some extreme level of reduction of energetic reserve of human body (Adephos), originating as a result of higher expenditure of energy in case of pregnancy, may cause impossibility of adaptive alternations and initiate pathologic processes in thrombocytes and vessels. Correction of Mg2+ Adephos content in blood of pregnant women with gestoses is capable to normalize the functional state of thrombocytes and vascular tone.
МЕДИЦИНСКИЕ ТЕХНОЛОГИИ
Arous M. M., Oleshkevich F. V., Tolpekin E. L.
Transcranial methods of endoscopic diagnostics and treatment of sacral osteochondrosis. pp. 82--86
Summary: The paper presents the experience of sacrolumbar pain syndromes diagnostic and treatment aminng 515 patients (1999--2001) by the transsacrum epidurofibroscopia. It allowed to reveal the pathology (cicatrix adhesive process which was impossible to visualize during CT) aminng 334 (65%) patients through physiological spine foramen with miniinvasion by reviewing epidural space throughout. Moreover, transsacral epidurofibroscopia at the same time allows to begin medical treatment: separating cicatrix adhesive process with the help of hydropreparation and medicine injection locality to the disc-radicular conflict. The operation is considered to be performed when the catheter is installed in the epidural space, which allows injecting the medicine for 3--4 days. After using this method 489 (95%) patients had favorable results. This fact gives an opportunity to avoid traditional surgical treatment (Standart Microdiscectomi Procedure).
Sidorovich R. R.
Method of transposition of Pectoralis major muschle in surgical treatment of brachial plexus trauma. pp. 87--91
Summary: In the course of anatomic and topographic examination of the pectoralis major (ten autopsies have been performed to do this) innervation and blood supply features of the muscle were inspected. Based on this, a technique has been proposed to carry out a bipolar transposition of the lower half of sternocostal and abdominal portions of the Pectoralis major, with the neurovascular bundle intact, in the place of a removed paralyzed biceps, with the forming of a tubularized flap, and extending its distal portions with a flap made from the thigh's broad fascia. In the post-operative period, 5 patients with a brachial plexus injury, the Erb-Duchenne paralysis-type, have shown excellent results of recovery following the use of the technique which has effectively led to the full restoration of the injured forearm's flexion function in all the patients.
Dedova L. N.
Vaciuim-d'arsonvalization as a new treatment of periodontium and oral mucous membrane diseases. pp. 92--98
Summary: The research objectivis to work out the scientific and systematic vacuum-d'arsonvalization principles in stomatology as well as to do a clinico-experimental research of its efficiency in treatment of periodontium and oral mucous membrane diseases.
The results obtained: The vacuum-d'arsonvalization efficiency has been obtained in treatment of periodontium and oral mucous membrane diseases. It has been established that vacuum-d'arsonvalization has no side effects, is well endured by patients, has no negative effect on oral cavity conditions, improves physiological resistance of periodontium tissues and oral mucous membrane, raises the traditional treatment methods efficiency in a number of stomatological diseases.
ОБЗОРЫ
Nikolaevich L. N., Demidchik E. P.
Apoptosis: biological and medical aspects. pp. 99--110
Summary: The paper concerns cellular and molecular mechanisms of apoptosis. Its parameters which are used for diagnosing oncologic diseases were analysed, with the possibility of their application as an independent factor for predicting solid tumors in patients being shown.
Shanko Y. G.
Modern principles of diagnostics and treatment of vestibulocochlear nerve neurinomas. pp. 111--118
Summary: The analysis of current problems of vestibular schwannomas diagnostic and treatment is presented. Radical removal of tumor is considered to be the main method of treatment. Surgical procedure can be carried out by the suboccipital retrosig-moid, translabyrintine and subtemporal transtentorial approaches. Each of them has its own advantages and disadvantages. In surgical treatment hearing preservation was achieved in 10--13% of cases, facial nerve preservation -- in more than 80% of cases. Postoperative mortality was 1--6%.
Maksimovich N. E.
Role of nitric oxide in genesis of brain damage during oxidative stress. pp. 119--124
Summary: Brain nitric oxide can play both protective and neurodestructive role in ischaemia and reperfusion. Endothelium nitric oxide improves cerebral blood flow and reduces a damage induced by ischaemia. Hyperproduction of the nitric oxide and oxygen radicals renders cytotoxic action on the neurocytes and endothelium leading to impairment of mechanisms of blood flow autoregulation in the brain and amplification of ischaemic damage.
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Разработана и поддерживается Николаем Н. Костюковичем. Последнее обновление: 17 февраля 2005 г.
Создана при участии Игнатия И. Корсака
Копирайт © 2004-2005 Национальная академия наук Беларуси
Копирайт © 2004 Издательство "Беларуская навука"
