Role of hypothalamo-hypophyseal-adrenal axis in the pathogenesis of arterial hypertension in patients with prolactinoma of the anterior lobe of the hypophysis

AIM: To elucidate mechanisms underlying arterial hypertension (AH) in patients with hyperprolactinemia, prolactin-secreting adenoma of the anterior lobe of the hypothesis, in particular. MATERIAL AND METHODS: 9 females with microprolactin-secreting and 4 females with macroprolactin-secreting adenoma of the anterior lobe of the hypophysis (mean age 33.8 +/- 3.7 years) were examined using radioimmunoassay of the hormones, computed tomography, MR-tomography of the adrenals and brain. RESULTS: Humoral regulation of the hypothalamic-hypophyseal-adrenal axis was found different in patients with microadenoma due to dopaminergic insufficiency of the hypothalamus and in patients with macroadenoma--tumor of the hypophyseal genesis. Patients with microadenoma were diagnosed to have low-renin diastolic arterial hypertension with clinical symptoms of hyperaldosteronism and high levels of plasma aldosterone. Patients with macroadenoma had normal arterial pressure, aldosterone levels and plasma renin activity. Treatment with parlodel, agonist of dopaminergic receptors, reduced arterial pressure, prolactin level, plasma aldosterone and raised plasma renin activity in patients with microadenoma. Such changes were not observed in patients with macroadenoma. CONCLUSION: It is suggested that one of the causes of AH in patients with microprolactin-secreting hypophyseal adenoma lies in hyperaldosteronemia which develops as a result of dopaminergic insufficiency of the hypothalamus and hyperprolactinemia.     

HIV／AIDS患者血清自身抗体检测结果分析

目的：了解 HIV /AIDS 患者血清中自身抗体的检出率,探讨自身免疫在 HIV /AIDS 患者中的意义。方法选择2008年1月至2012年10月云南省传染病专科医院门诊和住院就诊,并检测血清抗核抗体（ANA）和抗可提取性核抗原（ENA）等15种抗体的 HIV /AIDS 患者198例为观察组,另选择2012年健康体检者50例为健康对照组。采用间接免疫荧光法检测 HIV/AIDS 患者血清 ANA ;欧蒙印迹法检测自身抗体;流式细胞术检测 CD4＋T 淋巴细胞。比较两组间自身抗体检出率。结果观察组患者自身抗体总阳性率为27．8％,以 Ro-52阳性检出率最高,ANA 和 Ro-52与健康对照组比较差异有统计学意义（P ＜0．05）。 CD4＋ T 淋巴细胞低于200个/μL 的 HIV患者自身抗体检出率为37．1％,与高于200个/μL 的 HIV 患者比较差异有统计学意义（P＜0．01）。结论 HIV 感染能诱导自身免疫反应,使患者出现多种自身抗体,自身抗体的检出率与 CD4＋ T 淋巴细胞密切相关,监测 HIV 患者自身抗体对患者的诊断和治疗有一定的指导意义。     

Prognostic significance of total blood cholesterol level and the possibility of dietary correction of hypercholesterolemia in the population

In a population of males aged 40-59 years, a routine epidemiological survey was performed, which was followed by a 5-year follow-up to examine the mortality rates and incidence of myocardial infarction and stroke treated by an active prophylactic measure program (Group 1) and conventional regimen (Group 2). The total cholesterol levels of 260 mg/dl or more were found to be of highly prognostic value to death from all causes, largely cardiovascular diseases, to development of myocardial infarction, stroke, and to higher risk of fatal cases of the diseases. It was ascertained that it was difficult to modify the dietary habits in subjects of mature age. By the end of the fifth follow-up year, the examined patients from Group 1 showed a reduction in the mean level of total cholesterol and hypercholesterolemia rates, following by a decrease in total and cardiovascular mortality by 6.5 and 5.7%, respectively, the incidence of myocardial infarction and stroke and the risk of death from these complications becoming lower.     

The course of chronic circulatory insufficiency in patients with primary pulmonary hypertension]

A physical and X-ray examination and echo-, electro- and phonocardiographies were performed in 29 patients with primary pulmonary hypertension. Their central hemodynamics was also conducted by introducing a Swan-Ganz flowing balloon catheter into the right cardiac cavities. With evolving chronic circulatory insufficiency, the patients showed profound hemodynamic changes both in the right (end-diastolic pressure in the right ventricle and atrium rose and ventricular stroke index dropped) and left (heart rate increased, cardiac and stroke indices decreased in the ventricle) ventricles. There were slight changes in peripheral hemodynamics. Pulmonary pressure became lower, but this fact cannot be considered to be positive as this led to significantly lower right ventricular stroke index that indicates the critical diminution in right ventricular performance, unlike cases successfully treated with peripheral vasodilators.     

The role of computed spirometry in the epidemiological study of respiratory symptoms]

An epidemiological study was made of a random representative sample of men and women aged 25-64 years. There were 167 men and 306 women. In order to compare forced expiration in persons with different combinations of respiratory symptoms, potentialities of the use of the forced midexpiratory flow 25-75% together with the FEVC, FEV1, FEV1/FEVC were examined. Among the flow parameters, the forced midexpiratory flow has the least variability, which permits using it for diagnosis of obstructive disorders of lung ventilatory function. The studies revealed qualitative peculiarities in the changes of the spirography readings among men and women. As compared to the examinees without respiratory symptoms, men with cough and sputum manifested a decrease in the parameters characteristic of mixed changes in lung ventilatory function with the predominance of obstructive alterations in chronic bronchitis. The degree of obstructive disorders was higher than in women showing the analogous symptoms. As compared to the examinees without respiratory symptoms, women suffering from chronic bronchitis were marked by lower values of the volumetric parameters, without any signs of forced expiration deceleration.     

Percutaneous gastrostomy for enteral feeding

Over a period of 18 months, percutaneous nonendoscopic gastrostomy using the Seldinger technique was successfully performed in 32 adults for enteral feeding. There were no deaths or major morbidity related to the procedure. Three patients died of existing disease within 30 days; one had peritoneal irritation following dislodgement of the catheter two days after the procedure but responded to conservative treatment with antibiotics alone. The authors conclude that this procedure is simple and safe and represents the preferred method of gastrostomy for enteral feeding.     

Involvement of Transforming Growth Factor β and its Type 1 Receptor in the Development of Breast Cancer

Introduction of recent achievements of molecular biology into clinical practice contributes significantly to both prevention and early detection of breast cancer in women and development of new approaches, including genotyping, to screening for breast cancer. Screening for genetic polymorphisms in genes TGFβ1 and TGFβR1 reveals carriers of sporadic breast cancer. This provides an opportunity to reassess the role and place of preventive measures, also including surgical method, in the fight against breast cancer.