Role of ultrasound dopplerography with acute captopril test in assessment of renal hemodynamics in chronic glomerulonephritis

AIM: To examine blood flow in renal and intrarenal arteries and its changes in the acute pharmacological test with captopril in patients with chronic glomerulonephritis (CGN). MATERIAL AND METHODS: Renal circulation was studied in 50 patients with CGN using ultrasound dopplerography (USDG) of renal vessels on the unit GE Logiq 400 CL PRO Series. The velocity and indices of peripheral blood resistance in the major renal artery (RA) and in intrarenal arteries were estimated. In 26 patients the blood flow was studied again after intake of 50 mg captopril. RESULTS: Poor renal blood flow was registered in cortical parenchyma in 36% CGN patients (with chronic renal failure in 75%). Multifactorial regression analysis has demonstrated that only blood creatinine was independently related with slowing down of the blood flow at the level of RA and intrarenal arteries. Morphological index of activity correlated with resistance indices while a high sclerosis index correlated with blood flow slowing. Older patients had higher resistance indices. Captopril significantly accelerated blood flow and insignificantly changed indices of peripheral resistance including those in CRF patients. CONCLUSION: Poor blood flow in the cortical layer of renal parenchyma in CGN, according to USDG, occurs rather frequently and was associated with CRF and older age of the patients. Blocking of renin-angiotensin system at the level of angiotensin II formation improves renal blood flow in most of the patients.     

Prediction of cardiac complications during operations on the brachiocephalic arteries

The development of myocardial or brain ischemia is a major hazard to patients operated on the brachiocephalic arteries. The purpose of the present study was to reveal a risk factor or its group of factors whose correction would improve the prediction of surgical interventions as a whole. A preliminary study included 105 patients (among them there were males (80%), whose mean age was 60 +/- 0.77 years; females (20%) whose mean age was 64 +/- 1.38 years). It has shown that a significant individual impact on the occurrence of cardiac complications was produced by the following factors: the severity of angina pectoris (p = 0.01); diabetes mellitus (p = 0.01); transesophageal stimulation test (the presence of a low or moderate coronary circulatory reserve) (p = 0.02), hypertensive disease (p = 0.04). The likelihood of development of cardiological complications drastically increases with a rise in the number of significant risk factors of concomitant diseases. Their determining risk factors are hypertensive disease and postoperative arterial hypertension, which, in combination with other risk factors, provokes cardiac complications in the postoperative period. In the patients with the high predictable likelihood of cardiac complications during operations on the brachiocephalic arteries, the priority task is to stabilize blood pressure when the patients are prepared for surgery and to prevent unstable hemodynamics in the postoperative period.     

AN EXPERIMENTAL SYSTEM FOR THE SIMULTANEOUS ESTIMATION OF MITOSTATIC AND LYMPHOTOXIC EFFECTS OF IMMUNOSUPPRESSANTS AND CYTOSTATICS

Sublethally (600 R) irradiated (CBA x C57BL)F₁ mice were grafted intravenously with parental lymph node cells in doses ranging from 0.2 x 10⁶ to 12 x 10⁶. The transplantation of these lymphoid cells leads to inactivation of the recipient's endogenous CFU (as measured by the diminution of the number of colonies registered on the 10th day after irradiation). A 50% inactivation was observed when the graft size of the CBA cells was 0.52 x 10⁶. This figure for C57BL cells was 10 times more. This experimental system evaluates two simultaneously developing processes: the multiplication of endogenous CFU and the homograft reaction of transplanted lymphocytes against them. Both processes can be quantitatively estimated simultaneously in the same experiment by the determination of the number of colonies in corresponding experimental groups. Thus it was possible in a single experiment to compare quantitatively the effect of immunosuppressants on two points: (a) mitostatic action (suppression of CFU) and (b) lymphotoxic action. The latter, a true immunosuppressive effect, represents suppression of GVH activity of lymphoid cells and is demonstrated by abolition of the inhibition of endogenous colony formation. In the present system we have tested 6-MP, ALS, cyclophosphamide, hydrocortisone, and other drugs. The definite mitostatic and lymphotoxic doses of drugs are ascertained. Cyclophosphamide and ALS proved to be drugs with high dose ranges of selective lymphotoxic action. Hydrocortisone acetate had a more narrow range of selective lymphotoxic effect. 6-MP and Imuran (azathioprine) failed to exert any selective action on lymphoid elements. They possessed pronounced mitostatic efficiency, however.     

Prolonged epidural infusion of ropivacaine in the complex of anesthesiological protection at pancreatoduodenal surgery

The purpose of this study was to examine the expediency and efficiency of use of an infusion administration of naropine into the epidural space for intraoperative anesthesia and to develop the optimum procedure for administering this anesthetic during operations on the upper abdomen. Studies were performed in 43 patients operated on for different pancreatic diseases. Anesthesia based on epidural naropine infusion versus ataralgesia was compared. This study indicated that epidural naropine infusion-based anesthesia provides stable hemodynamic parameters and reduces the use of narcotic analgesics by more than twice. Inclusion of prolonged epidural infusion of 0.3% naropine solution into the anesthesiological appliance scheme during this type of operations provides an adequate antinociceptive protection and contributes to the early activation of patients, which prevents the development of postoperative complications.     

Serum concentrations of trace elements and microcirculation during laser therapy for pneumonia

The impact of laser therapy in the multimodality treatment for pneumonia on the serum levels of trace elements and microcirculation was studied. A total of 105 patients with pneumonia were examined. The patients were divided into 2 groups: 1) 68 patients received laser therapy and 2) 37 patients took drug therapy alone. There was a more substantial reduction in the permeability of cellular membranes, a significant increase in the serum levels of iron and chromium, better circulation at the expense of a vascular component. The above changes highly correlated with laboratory data and external respiratory function parameters.     

Patterns of nucleotide substitution in Drosophila and mammalian genomes

To estimate patterns of molecular evolution of unconstrained DNA sequences, we used maximum parsimony to separate phylogenetic trees of a non-long terminal repeat retrotransposable element into either internal branches, representing mainly the constrained evolution of active lineages, or into terminal branches, representing mainly nonfunctional “dead-on-arrival” copies that are unconstrained by selection and evolve as pseudogenes. The pattern of nucleotide substitutions in unconstrained sequences is expected to be congruent with the pattern of point mutation. We examined the retrotransposon Helena in the Drosophila virilis species group (subgenus Drosophila) and the Drosophila melanogaster species subgroup (subgenus Sophophora). The patterns of point mutation are indistinguishable, suggesting considerable stability over evolutionary time (40–60 million years). The relative frequencies of different point mutations are unequal, but the “transition bias” results largely from an ≈2-fold excess of GC to AT substitutions. Spontaneous mutation is biased toward AT base pairs, with an expected mutational equilibrium of ≈65% A + T (quite similar to that of long introns). These data also enable the first detailed comparison of patterns of point mutations in Drosophila and mammals. Although the patterns are different, all of the statistical significance comes from a much greater rate of GC to AT substitution in mammals, probably because of methylated cytosine “hotspots.” When the GC to AT substitutions are discounted, the remaining differences are considerably reduced and not statistically significant.     

Tension-free plasty in the surgery of abdominal wall hernias

The article presents an experience with application of tension-free plasty of the anterior abdominal wall using reticular endoprostheses. New endoprostheses of Reperen are developed and applied, a method of sutureless fixation of polypropylene net in the abdominal wall tissues is proposed when performing plasty for great ventral hernias. Advantages of new methods are shown compared with analogs both in selective and in emergency surgery, in different age groups of patients. The direct and long-term postoperative results and parameters of quality of life are investigated.     

Antioxidant and membranoprotector treatment of chronic pyelonephritis

The results of investigation of the clinical efficiency of using the antioxidant drug cytoflavin in a complex therapy of patients with chronic pyelonephritis prior to development of azotemia are presented. It is shown that cytoflavin in combination with basic therapy reduces the intensity of lipid peroxidation processes (as monitored using diene conjugates, malonic dialdehyde, and Schiffbase metabolites) with retention of the antioxidant status. The proposed treatment normalizes the ratio of blood plasma phospholipid fractions and erythrocytes membranes.     

Pharmacological neuroprotection against brain damage in ischemiai/reperfusion experiment

Experiment carried out on laboratory animals (rats) were aimed at comparative evaluation of the effect of several neuroprotective drugs under the conditions of model brain ischemia-reperfusion. The experimental methods included staining of brain tissue sections by hematoxiline-eosine, Nissl staining, and expression of NOS1, NOS3, TRAIL by imunnohistological means. The intensity of damage in various parts of brain and the nature of apoptosis without neuroprotection and with popular neuroprotectors (cytoflavin, actovegin, mexidol) and a test drug at the stage ofpreclinical trial (AKF-90-7) were evaluated. Characteristic cytotoxic (coagulative pycnomorphic and colliquative necrosis of neurons) and vascular (hemostasia, erythropedesis) changes were revealed. The neuroprotective effectof drugs decreases in the following order: AKF-90-7 > cytoflavin > actovegin > mexidol.