[The role of comprehensive geriatric assessment in the treatment of cancer patients in elderly and senile age.]

Modern approaches to the organization of diagnosis and treatment of elderly and senile patients with malignant tumors allow to maintain the necessary level of health, improve the quality of life and increase life expectancy. Assessment of geriatric status in Oncology allows: to predict complications during the complex treatment, including drug treatment; to modify treatment to reduce the risk factors of adverse outcomes; to select patients for specialized treatment using standard schemes. So, timely assessment of geriatric syndromes and their correction can expand the indications for specialized treatment of elderly and senile patients.

Possibilities and perspectives of human typologies taking into account in dentistry

OBJECTIVE

Introduction: Such sciences as differential physiology, differential psychology, differential anatomy and chemistry are developed greatly nowadays. They deal to human typologies. The scientific works big amount concerning dentistry in this aspect allows speaking about differentiated dentistry. The aim: To assess control locus in the UMSA Ukrainian students dependently on their dominant extremity as well as to assess and to compare face asymmetry expression in the guys and girls from Egypt and Ukraine studying at different courses.

PATIENTS AND METHODS

Materials and methods: 50 Ukrainian students from dental faculty different courses in the 1st series of the experiments, 18 girls and 18 guys from Egypt and Ukraine in the 2nd series. Methods: - determining the dominant extremity and control locus by survey; - computer modeling for facial expression assessment.

RESULTS

Results: 43 students (85%, p<0,01) independently on dominant extremity demonstrate control internal locus and only 7 people (comprising 15%, p<0,01), 6 people (90%, p<0,01) from which were left-handers and all ambidexters) - the external one. These were the 1st experimental series results. We received following results in the experiment second part. Faces of the students from Egypt, guys in bigger extent, were more asymmetrical. We were taking photos of the students and then were measuring longitudinal and transversal sizes of face right and left halves. 10 guys from Egypt (55,6%, p<0,01) and 5 girls from Ukraine (27,78%, p<0,01) were distinguished by bigger longitudinal and transversal sizes as well as looked less harmonic while coinciding the face left halves than the right ones that can be explained in part by primary usage of left side while masticating as well as left hand usage at writing (in part in the Egyptian guys).

CONCLUSION

Conclusions: We consider that our work can have significance in Maxillary-Facial and Plastic Surgery, Transplantology, Orthopedy, Prosthetic Dentistry, Neurology as well as Cosmetology and Psychology.

[Optimization of cognitive rehabilitation of elderly patient with motor disorders on the basis of modern digital technologies.]

The problem of cognitive dysfunction in modern gerontological aid goes to the leading positions, complicating treatment and rehabilitation of concomitant motor disorders. The current trend in recent years is the search and development of models of cognitive rehabilitation of elderly patients on the basis of digital technology with the ability to transfer the effect on the motor and mental sphere. The literature sources of the last 5-7 years describe dozens of methods of cognitive rehabilitation, including on the basis of computer games, which demonstrate the importance of these techniques not only in improving the cognitive abilities of patients, but also in Preservation of social adaptation and daily functioning. At the same time negligible attention is paid to the problem of application of digital technologies in rehabilitation of cognitive disorders in patients with motor disorders and possible transfer of effect between spheres. This study shows the application of the algorithm of action with the participation of electronic devices as cognitive rehabilitation with compensatory mechanism in comorbid patients with motor and moderate cognitive impairment.

[The first results of assessment of clinical efficacy of melatonin and metformin in patients with disseminated skin melanoma receiving dacarbazine as first-line systemic therapy]

The aim of the study was to assess efficacy and safety of combined therapy with dacarbazine and melatonin or metformin in comparison with dacarbazine alone in the 1st line of therapy of cutaneous melanoma. Thirty-six patients with disseminated melanoma, therapy naïve, were included between March 2014 and December 2015. Patients received DTIC 1000 mg/m2 in day 1 of 28-day cycle either as monotherapy (group 1) or in combination with melatonin 3 mg PO daily (group 2) or metformin 850 mg 2 times a day PO daily (group 3). Thirty-four patients were randomized (15-in group 1, 8 - in group 2, 13 - in group 3) and received 119 cycles of therapy. Response rate was 11% in groups 1 and 2, and 8,3% - in group 3 (p=0,57). Median time to progression was 52, 79 and 63 days, respectively in the 1st, 2nd and 3rd group (р=0,468). Two patients from the 2nd and 3rd group showed delayed response to therapy. No adverse events of grade 3-4 were seen. Thus, DTIC with melatonin or metformin was well tolerated. No meaningful increase of adverse event incidence was seen. No benefit of either combination was shown in this interim analysis. Delayed responses in melatonin and metformin combination groups were registered. This suggests immunologic effect of both drugs and warrants further study.

[Impact of bariatric surgery on vitamin metabolisms in obese patients]

AIM

To investigate the impact of bariatric surgery (BS) on the level of vitamins in obese patients.

SUBJECTS AND METHODS

One hundred obese patients (78 women and 22 men) aged 19 to 61 years were examined. Controlled gastric banding (CGB) was carried out in 20 patients (mean body mass index (BMI), 41.3 ± 8.2 kg/m2); gastric sleeve resection (GSR) in 40 patients, and gastric shunting (GS) in 40 (the mean BMI in these groups were 41.1 ± 17.8 and 45.9 ± 6.2 kg/m2, respectively). A control group consisted of 10 apparently healthy individuals (BMI, 24.9 ± 3.2 kg/m2). An enzyme immunoassay was used to determine the serum concentrations of vitamins B1, B2, B5, B6, B9, B12, C, and D, niacin, biotin, and retinol-binding protein (RBP) before and 1 year after surgery.

RESULTS

All the three groups showed a considerable decrease in the levels of vitamins C, B5, B6, and D, and RBP both prior to and following BS. More than 50% of the patients who had undergone GSR had also a lower baseline niacin level. A year after CGB, GSR, and GS, the number of patents with deficiency of these vitamins remained the same or increased. The majority of patients with the same level of vitamin B2, niacin, and folic acid (FA) were observed to have its decrease a year postsurgery. The concentration of the other test vitamins was also reduced a year after all operations; however, it remained within the normal range. GS had no substantial impact on the concentrations of FA, vitamins B2, B12, B1, and biotin. The lower serum vitamin levels were not accompanied by clinical symptoms in most patients following BS.

CONCLUSION

In 80% of the patients with obesity, the levels of vitamins C, B6, and D were decreased to a variable degree. After BS, there was a rise in the number of patients with low serum vitamin C, D, B6, B5, niacin, FA, and RBP concentrations, at the same time the number of patients with FA deficiency increased by more than twice. BS did not significantly affect the metabolism of vitamins B1 B2 B12, and biotin.

[THE CHANGE IN THE CONCENTRATION OF VITAMINS AFTER BARIATRIC SURGERY]

AIM

to study the concentration of vitamins in obese patients after bariatric surgery (BS).

MATERIAL AND METHODS

A total of 100 obese patients aged 19 to 61 years (78 women, 22 men). 20 patients (mean body mass index (BMI)--41.3 ± 8.2 kg/m²) had adjustable gastric banding (AGB), 40 patients--sleeve gastrectomy (SG) and 40--gastric bypass (GB) (mean BMI Group 41.1 ± 17.8 kg/m², and 45.9 ± 6.2 kg/m², respectively). The control group consisted of 10 healthy subjects (BMI--24.9 ± 3.2 kg/m²). We determined the serum level of vitamins B₁, B₂, B₅, B₆, B₉, B₁₂, C, D, niacin, biotin, and retinol-binding protein (RBP) before surgery and 1 year after it.

RESULTS

There was a significant reduction ofvitamins C, B₆, B₅, D and RBP both before and after BS. More than half of patients after SG, also had initial reduction of niacin. A year after BS (AGB, SG, GB) the number of patients with deficiency of these vitamins remained the same or increased. Most patients with normal or even elevated levels ofvitamin B₂, niacin and folic acid, has been declining a year after BO. The concentration of the rest of the vitamins also significantly decreased a year after all operations, but their performance remained within normal limits.

CONCLUSION

Levels of vitamins C, B₆ and D were reduced in more than 70% patients with obesity. The number of patients with low levels of vitamin C D, B₆, B₅, niacin, folic acid and RBP increased after BS. BS does not have a significant effect on the metabolism ofvitamins B₁, B₂, B₁₂ and biotin.

Anti-resorptive agents reduce the size of resorption cavities: a three-dimensional dynamic bone histomorphometry study

Alterations in resorption cavities and bone remodeling events during anti-resorptive treatment are believed to contribute to reductions in fracture risk. Here, we examine changes in the size of individual remodeling events associated with treatment with a selective estrogen receptor modulator (raloxifene) or a bisphosphonate (risedronate). Adult female rats (6months of age) were submitted to ovariectomy (n=17) or sham surgery (SHAM, n=5). One month after surgery, the ovariectomized animals were separated into three groups: untreated (OVX, n=5), raloxifene treated (OVX+Ral, n=6) and risedronate treated (OVX+Ris, n=6). At 10months of age, the lumbar vertebrae were submitted to three-dimensional dynamic bone histomorphometry to examine the size (depth, breadth and volume) of individual resorption cavities and formation events. Maximum resorption cavity depth did not differ between the SHAM (23.66±1.87μm, mean±SD) and OVX (22.88±3.69μm) groups but was smaller in the OVX+Ral (14.96±2.30μm) and OVX+Ris (14.94±2.70μm) groups (p<0.01). Anti-resorptive treatment was associated with reductions in the surface area of resorption cavities and the volume occupied by each resorption cavity (p<0.01 each). The surface area and volume of individual formation events (double-labeled events) in the OVX+Ris group were reduced as compared to other groups (p<0.02). Raloxifene treated animals showed similar amounts of bone remodeling (ES/BS and dLS/BS) compared to sham-operated controls but smaller cavity size (depth, breadth and volume). The current study shows that anti-resorptive agents influence the size of resorption cavities and individual remodeling events and that the effect of anti-resorptives on individual remodeling events may not always be directly related to the degree of suppression of bone remodeling.

Power-controlled phase-matching and instability of CW propagation in multicore optical fibers with a central core

We present modulation instability analysis including azimuthal perturbations of steady-state continuous wave (CW) propagation in multicore-fiber configurations with a central core. In systems with a central core, a steady CW evolution regime requires power-controlled phase matching, which offers interesting spatial-division applications. Our results have general applicability and are relevant to a range of physical and engineering systems, including high-power fiber lasers, optical transmission in multicore fiber, and systems of coupled nonlinear waveguides.

[Diagnostic value of serum markers of fibrosis in chronic liver diseases]

AIM

To estimate the diagnostic value (DV) of direct markers of liver fibrosis, such as type IV collagen (C-IV), hyaluronic acid (HA), tissue inhibitor of metalloproteinases-1 (TIMP-1) in combination with indirect markers of fibrosis, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (gamma-GTP), alkaline phosphatase (ALP), platelets, tumor necrosis factor-alpha (TNF-alpha) in evaluating liver fibrosis.

SUBJECTS AND METHODS

Sixty-seven patients with chronic diffuse liver diseases were examined. ALT, AST, gamma-GTP, and ALP were determined as indirect indicators of fibrosis. The levels of TIMP-1, HA, C-IV, and TNF-alpha were estimated by ELISA; the stage of fibrosis was determined by the results of indirect liver ultrasound fibroelastography (FE).

RESULTS

According to the results of FE, the patients were divided into 2 groups: 1) (n = 25) F < or = 2 METAVIR and 2) (n = 42) F3-F4. While estimating DV of severe fibrosis stages (F3-F4), the area under the ROC curve (AUC) increased for platelets, HA, and C-IV. DV of ALT, AST declined with the higher degree of fibrosis. The highest ratio of test specificity and sensitivity (TSp and TSen) and AUC were observed for AST and HA. ALT and platelets showed low TSen, and TNF-alpha and TIMP-1 had no TSp. For evaluation of fibrosis (F4), a HA increase of over 57.7 ng/ml had 92.6% TSen and 67.5% TSp; for a C-IV elevation of above 133.1mkg/l, TSen was 85.2%, TSp was 57.5%; for a TIMP-1 rise from 24.4 ng/ml, TSen was 74.1% and TSp was 62.5%. For the diagnosis of fibrosis (F4) with a HA rise of more than 57.7 ng/ml, DV of a positive test was 65.8 (48.65-80.4; 95% CI) and that of a negative test was 93.1 (76.8-99.2; 95% CI). Thus, the negative rather than positive test results are of great diagnostic value for evaluation of the degree of fibrosis.

CONCLUSION

The results of the investigation convincingly suggest that examination of the serum markers of fibrosis allows one to estimate with a high probability its presence and severity in patients with hepatic cirrhosis. The so-called direct markers (substances reflecting the biochemistry and regulation of fibrogenesis) are undoubtedly of great diagnostic value.

Three-dimensional characterization of resorption cavity size and location in human vertebral trabecular bone

The number and size of resorption cavities in cancellous bone are believed to influence rates of bone loss, local tissue stress and strain and potentially whole bone strength. Traditional two-dimensional approaches to measuring resorption cavities in cancellous bone report the percent of the bone surface covered by cavities or osteoclasts, but cannot measure cavity number or size. Here we use three-dimensional imaging (voxel size 0.7×0.7×5.0 μm) to characterize resorption cavity location, number and size in human vertebral cancellous bone from nine elderly donors (7 male, 2 female, ages 47-80 years). Cavities were 30.10 ± 8.56 μm in maximum depth, 80.60 ± 22.23∗10(3) μm(2) in surface area and 614.16 ± 311.93∗10(3) μm(3) in volume (mean ± SD). The average number of cavities per unit tissue volume (N.Cv/TV) was 1.25 ± 0.77 mm(-3). The ratio of maximum cavity depth to local trabecular thickness was 30.46 ± 7.03% and maximum cavity depth was greater on thicker trabeculae (p<0.05, r(2)=0.14). Half of the resorption cavities were located entirely on nodes (the intersection of two or more trabeculae) within the trabecular structure. Cavities that were not entirely on nodes were predominately on plate-like trabeculae oriented in the cranial-caudal (longitudinal) direction. Cavities on plate-like trabeculae were larger in maximum cavity depth, cavity surface area and cavity volume than cavities on rod-like trabeculae (p<0.05). We conclude from these findings that cavity size and location are related to local trabecular microarchitecture.

Mechanical failure begins preferentially near resorption cavities in human vertebral cancellous bone under compression

The amount of bone turnover in the body has been implicated as a factor that can influence fracture risk and bone strength. Here we test the idea that remodeling cavities promote local tissue failure by determining if microscopic tissue damage (microdamage) caused by controlled loading in vitro is more likely to form near resorption cavities. Specimens of human vertebral cancellous bone (L4, 7 male and 2 female, age 70±10, mean±SD) were loaded in compression to the yield point, stained for microscopic tissue damage and submitted to three-dimensional fluorescent imaging using serial milling (image voxel size 0.7×0.7×5.0 μm). We found the resulting damage volume per bone volume (DV/BV) was correlated with percent eroded surface (p<0.01, r(2)=0.65), demonstrating that whole specimen measures of resorption cavities and microdamage are related. Locations of microdamage were more than two times as likely to have a neighboring resorption cavity than randomly selected sites without microdamage (relative risk 2.39, 95% confidence interval of relative risk: 2.09-2.73), indicating a spatial association between resorption cavities and microdamage at the local level. Individual microdamage sites were 48,700 (40,100; 62,700) μm(3) in size (median, 25th and 75th percentiles). That microdamage was associated with resorption cavities when measured at the whole specimen level as well as at the local level provides strong evidence that resorption cavities play a role in mechanical failure processes of cancellous bone and therefore have the potential to influence resistance to clinical fracture.

Influence of a specific ginger combination on gastropathy conditions in patients with osteoarthritis of the knee or hip

BACKGROUND

Nonsteroid anti-inflammatory drugs represent an important osteoarthritis (OA) therapy component, but also a leading cause of gastropathy: one of the most frequent and serious OA therapy complications. The aim of the present study was to study the influence of GI health in an OA population receiving either ginger or diclofenac.

METHODS

Forty-three (43) patients with confirmed OA (knee and hip) were included in a randomized controlled study. A ginger group of 21 patients (17 women, 4 men) was given a specific ginger combination daily (340 mg EV.EXT 35 Zingiber officinalis extract) for 4 weeks. A diclofenac group (positive control) of 22 patients (18 women, 4 men) received 100 mg diclofenac daily for the same period. Both groups also received 1000 mg glucosamine daily. Gastrointestinal pain and dyspepsia were evaluated according to the severity of dyspepsia assessment (SODA) form. Patients also underwent esophagogastroduodenoscopy (EGDS) including biopsy before and after the treatment. Serum gastrin-17 levels, and stomach mucosa prostaglandins (PG) E1, E2, F2α, and 6-keto PGF1α (PGI2) levels were measured. Arthritic pain was evaluated using the visual analogue scale (VAS) on standing and moving.

RESULTS

The ginger group showed a slight but significantly lowered SODA pain and no change of SODA dyspepsia. EGDS showed significantly increased levels of PGE1, PGE2, and PGF2α in the stomach mucosa. This rise in gastric mucosa PG levels correlated with an increase in serum gastrin-17. On the other hand, the diclofenac group showed increased SODA pain and dyspepsia values with a corresponding significant decrease of stomach mucosa prostaglandins and general negative stomach mucosa degeneration. Both groups showed a relevant and significantly lowered VAS pain both on standing and moving.

CONCLUSIONS

The ginger combination is as effective as diclofenac but safer in treating OA, being without effect on the stomach mucosa. The increased mucosal PGs synthesis in the ginger group supports an increased mucosa-protective potential. VAS; visual analogue scale, 0-100 mm.

[Antiproliferative activity of diclofenac at tumor cell cultures]

It is known that for risk group's importance of early diagnostics and prevention of a cancer of a thick section of the intestines. The view was expressed that the use of nonsteroidal anti-inflammatory drugs prospectively. The article presents the data obtained after the determination of the effect on the domestic drug diclofenac on the ability of the lines of tumor cells of the human colon multiply this antiproliferativoe action on the dose of the drug. Used photometric method for determination antiproliferativoe action. In vitro determined the effect of the national drug diclofenac on the ability of the lines of tumor cells of the human colon multiply, and is set in a dose-dependent effect. It is established that under the action of NSAIDS metabolic activity of cells can both strengthen and weaken that depends on the line of tumor cells and the concentration of the drug.

[Clinical and diagnostic significance of gepsidin level in the regulation of iron metabolism in patients with inflammatory bowel disease]

Gepsidin is an iron regulatory protein that inhibits ferroportin, limiting the transport of iron into the cell of the small intestine villi and blocking the exit of iron from macrophages, that often leads to disruption of iron homeostasis, iron deficiency and the development of anemia. The Aim was to study the levels of gepsidin in patients with IBD and determine its prognostic significance for the development of anemia. We examined 80 patients with IBD, 45 (56%) men and 35 (44%) women with the average age of 39,0 +/- 15,8 years. In 40 patients with anemia and 40 patients with IBD without anemia syndrome, studies were conducted in the status of iron metabolism, the level of gepsidin, TNF, C-reactive protein.

CONCLUSION

IBD with systemic inflammatory response leads to increased levels gepsidina and increases the risk of anemia in IBD. Determination of gepsidin in IBD patients enables identify patients at risk for anemia and to clarify the effectiveness of the basic treatment of the disease.

[Modeling damage of the mucous membrane of the gastrointestinal tract in rats]

We studied the effect of NSAIDs on the stomach lining and intestines. Animals received the selective and nonselective NSAIDs. Revision of the abdominal cavity was performed after 24 hours and 14 days. In the mucosa was determined by the levels of prostaglandins and measured the index of damage. Lowering the synthesis of PG in the mucosa of the gastrointestinal tract contributes to the formation damage. After 24 hours when receiving non-selective COX inhibitors and selective inhibitors of COX-2 revealed the presence of mucous membrane lesions that are smaller than in groups of animals treated with selective NSAIDs. After 14 days of reception remains a low level of GHGs in the group of animals treated with nonselective NSAIDs. Visually mucosal damage are insignificant, but in the submucosal layer preserved microcirculatory blood flow disturbances.

[Protein that binds fatty acids (I-FABP)--a new perspective evidence for injury of the small intestine]

The article presents literature data on the diagnostic value of the new indicator of the epithelial damage of the small intestine--I-FABP (protein binding fatty acids) and the results of our investigation of this indicator in 63 patients with functional bowel disease, and 20--the control group presented patients with erosive gastritis. Also presented diagnostic value of this indicator and defined the boundaries of normal values for this indicator.

[Hormonal component of the gastrointestinal diseases pathogenesis]

This article summarizes results of numerous experimental and clinical studies conducted in the laboratory of gastrointestinal hormones CSRIG that was made to examine the endocrine status and metabolic changes in the digestive system with its physiological and pathological conditions.

[Stages of chronic pancreatitis development]

AIM

To ascertain correlations between pancreatic secretion disturbances and stage and complications of chronic pancreatitis (CP).

MATERIAL AND METHODS

The examination covered 81 CP patients (32 females, 49 males, mean age 55.9 +/- 1.8 years). Alcohol pancreatitis (AP) was diagnosed in 52 of them, biliary pancreatitis--in 29, complicated pancreatitis--in 25 patients. The control group consisted of 22 patients without symptoms of gastrointestinal disease.

RESULTS

By the results of clinical, device, laboratory and morphological tests we recognize 3 variants of CP course. Variant A: duration under 5 years, distinct pain syndrome, pancreatic fecal elastase (E-1) level insignificantly decreased, elevated blood levels of acetylcholine (Ac), serotonin (5-NT), cholecystokinin (CCK), secretin is subnormal. Pancreatic tissue is inflamed and swollen. Variant B: duration 5-10 years, E-1 under 100 mcg/g, moderate pain syndrome, prevalence of 5-NT as a stimulator of pancreatic secretory activity. CCK is high and secretin is low. Further progress of fibrous changes by ultrasound investigation, abdominal CT leads to calcinosis in pancreatic tissue. Variant C: duration 10 years and longer, weak pain syndrome, further rise of 5-NT concentration, decompensation of regulatory mechanisms of secretory pancreatic activity, CCK is high, secretin is subnormal.

CONCLUSION

Changes in correlations between neuromediators and hormones in CP reflect adaptation aimed at retension of secretory pancreatic activity in significant fibrous changes of pancreatic tissue.

[Thyroid dysfunction and soft fatty liver disease]

This review discusses the correlation of thyroid dysfunction and non-alcoholic fatty liver disease.

[Features of chronic pancreatitis in the elderly patients]

The aim of this study was to determine the severity of the exocrine and endocrine insufficiency of the pancreas, HC composition and state of homeostasis in the elderly patients. Was obsercved 76 patients with CP (46 females, 30 males), of whom 20 patients diagnosed alcoholic pancreatitis (AP) aged 30 to 55 years. At 26 patients was marked biliary pancreatitis (BP), age of patients was 35-60 years and at 30 was found involutional pancreatitis (IP) from 60 to 74 years, 15 people (with no signs of lesions of the gastrointestinal tract) consisted the control group. The diagnosis of CP was made on the basis of clinical data, laboratory and instrumental investigations. Depending on the etiology of chronic pancreatitis was revealed a different degree of impairment of exocrine and endocrine functions of pancreas. These changes were more pronounced in patients with AP, which depended on the severity of the disease and the presence of complications. In duodenal bile of patients was significantly progressive decrease in the total content of the HC, which depended on the reduction of the total content of the conjugates. Revealed a qualitative change in HC composition may reduce absorption of exogenous cholesterol in the intestine of patients with CP, and is one of the reasons affecting the state of the exocrine pancreas. These changes are especially pronounced in patients with IP. All patients with CP were observed on blood hypercoagulation, which was accompanied by a decrease in the overall constant blood clotting, increasing content of F, an increase in the index of coagulation and clot elasticity. Especially pronounced these changes were in patients with complicated disease and the elderly patients.

[Morphological changes in the structure, regional blood circulation and content of the prostaglandins in the rats intestinal mucosa at different NSAIDS effects]

In the experiment on white rats reproduced the damage to the intestinal mucosa after administration of selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) within 24 hours and for 14 days. After the autopsy was measured the index injury (II), the content of prostaglandins (PGs) and cytokines in extracts of intestinal mucosa. Was established that the reduction of PGs was combined with an increase in II. Long reception of NSAIDs (14 days) causes greater damage to the submucous layer, without visible macroscopic changes.

[Changes in concentration of cholecystokinin-pancreozymin in patients with cholelithiasis before and after cholecystectomy]

The level of cholecystokinin and secretin in 50 patients after cholecystectomy (from 1 to 10 years ago) was analyzed to study connection between cholecystectomy and gastrointestinal hormones concentration. 30 patients with gall bladder stone disease were included into the group of comparison. Cholecystokinin and secretin concentration in the groups of research was compared with indicated hormones concentration in the group of control formed of healthy volunteers. After anamnestical clinical and diagnostical features in every group had been studied we concluded, that cholecystokinin level changes depending on period after operation and outflow of bile conditions.

[The role of hormones and types of food behavior in the development of metabolic syndrome]

THE AIM

To investigate the role of hormones and the types of FB in the development of morbid obesity (MO), to develop a treatment policy for MO to examine the diagnostic predictive value of the FB hormones and FB modifications.

MATERIALS AND METHODS

Were investigated 67 patients: 28 (42%) males and 39 (58%) female aged 18 to 60 years under the scheme: medical history, questionnaire on the questionnaire SF-36, score types of FB, the study of the anthropometric data (OT/OB, BMI), the definition of the FB hormones with subsequent control of BMI, OT/OB dynamics, types and FB hormones.

RESULTS

In patients older than 50 years were dominated abdominal FB, in patients younger than 50 years - all three types of FB in approximately equal proportions. After the decline in MT was observed pattern between the FB modification and age of the patient. There was an increase of leptin and ghrelin and decrease in serotonin at all three types of FB. After weight correction was a decreased leptin, ghrelin, and increased serotonin, but the achievement of normal numbers are not marked. The paradoxical result is related to a violation of reciprocal relations of hormones.

CONCLUSIONS

In patients with MO FB hormone levels (Leptin, Ghrelin) elevated to normal values, reduced levels of serotonin, there is an infringement of their reciprocal correlations. The approach to patients should be lengthy and complex, involving multidisciplinary team aimed at FB correcting the with the rejection of improper food stereotype. In the treatment of MO must used different methods: reducing diet, physiotherapy effects, drug therapy and their combination with the selection of individual programs, taking into contraindications account. For the above techniques inefficiency is necessary to use surgical treatment. Correction of FB in patients older than 50 years is the most difficult task (due to the presence of concomitant diseases). Necessary to draw attention and to start treatment at a young age.

Three-dimensional surface texture visualization of bone tissue through epifluorescence-based serial block face imaging

Serial block face imaging is a microscopy technique in which the top of a specimen is cut or ground away and a mosaic of images is collected of the newly revealed cross-section. Images collected from each slice are then digitally stacked to achieve 3D images. The development of fully automated image acquisition devices has made serial block face imaging more attractive by greatly reducing labour requirements. The technique is particularly attractive for studies of biological activity within cancellous bone as it has the capability of achieving direct, automated measures of biological and morphological traits and their associations with one another. When used with fluorescence microscopy, serial block face imaging has the potential to achieve 3D images of tissue as well as fluorescent markers of biological activity. Epifluorescence-based serial block face imaging presents a number of unique challenges for visualizing bone specimens due to noise generated by sub-surface signal and local variations in tissue autofluorescence. Here we present techniques for processing serial block face images of trabecular bone using a combination of non-uniform illumination correction, precise tiling of the mosaic in each cross-section, cross-section alignment for vertical stacking, removal of sub-surface signal and segmentation. The resulting techniques allow examination of bone surface texture that will enable 3D quantitative measures of biological processes in cancellous bone biopsies.

[Etiology and pathogenesis of duodenal mucosa lesion in chronic pancreatitis]

AIM

To measure content of neuromediators (acetylcholine-Ach, serotonin-5-NT) and gastrointestinal hormones (cholecystokinine-CCK and secretin) in the blood serum of patients with chronic pancreatitis (CP); to study protective properties of the mucus in the duodenum in CP.

MATERIAL AND METHODS

CCK and secretin concentrations were estimated by enzyme immunoassay, Ach and 5-NT were measured biochemically basally and after standard meal in 65 CP patients and in the control group. Proteolytic activity of the mucus was assessed by Anson's method. An inhibitory property of the mucus was studied by residual proteolytic activity of pepsine after its incubation with mucus.

RESULTS

In AP patients the response of biologically active substrates to standard meal changed: 5-NT concentration rose from 0.40 +/- 0.07 to 0.55 +/- 0.05 mcg/ml (p < 0.05) while Ach dropped from 1.7 +/- 0.3 to 1.6 +/- 0.3 mmol/l (p > 0.05). BP patients responded to the standard meal with 5-HT concentration rise from 0.28 +/- 0.04 to 0.43 +/- 0.05 mcg/ml (p < 0.05), Ach changed insignificantly (from 1.5 +/- 0.12 to 1.45 +/- 0.21 mmol/l, p > 0.05, reselectively). CCK after standard meal significantly rose both in AP and BP. AP and BP patients had strong direct correlation between concentrations of 5-HT and CCK (r = 0.875439) and weak negative correlation with Ach level (r = -0.2209). In AP and BP patients secretin level weakly negatively correlated both with 5-NT and Ach levels (r = -0.4839 and r = -0.33207, respectively). Reduction of secretin secretion diminished secretion of bicarbonates and mucus with simultaneous change in the quality of mucous gel.

CONCLUSION

In CP of various etiology there are changes in the level and proportions of neuromediators and hormones causing alterations in the regulation system. These disorders correlate with disturbances in pancreatic excretory function and destructive tissue changes. Bicarbonates secretion decreases and changes quality of the secreted mucus.

[The role of E2 and F2alpha prostaglandins in development of erosive-ulcerative lesions of the gastroduodenal region]

THE PURPOSE OF THE STUDY

To study role of E2 and F2alpha prostaglandins in development of erosive-ulcerative lesions of gastrointestinal tract.

MATERIALS AND METHODS

were examined patients with mucosal erosive-ulcerative and inflammatory lesions of gastrointestinal tract, as well as patients with osteoarthritis who received selective and non selective NSAIDs. Determination of E2 and F2alpha endogenous PG group was investigated with help of immunefuoration method with help of R&D Systems, Inc. Control group was 15 healthy patients.

RESULTS

in presented work you can find that there is relationship between degree of reduction of PG level and severity of gastrointestinal mucosal lesion area. The lowest values of PGE2 and PG F2alpha observed in patients with gastric ulcer disease, especially during exacerbation. Patients with low PG synthesis in body increases likelihood of gastropathy as to reception of non-selective COX inhibitors, and at receiving selective COX-2 inhibitors.

[Pathophysiology of hormonal, immune, metabolic changes in acute and chronic pancreatitis. Experimental and clinical studies]

There is literature review of the acute and chronic pancreatitis experimental models. Patogenetic necrosis mechanisms with fibrosis progress in pancreas were revealed. The stimulation of the proteolytic enzymes synthesis and secretion, that was examined in experiments were compared with clinical examinations. The patients with chronic pancreatitis were investigated in the Central Research Institute of Gastroenterology.

[Impairment of humoral regulation of exocrine pancreatic function in chronic pancreatitis]

AIM

To elicit the role of cholecistokinin (CCK), biogenic amines, bile acids (BA) in development of functional pancreatic insufficiency (PI) in chronic pancreatitis (CP).

MATERIAL AND METHODS

Blood concentrations of CCK, serotonin and acetylcholin, fecal concentration of elastase (E-1), BA spectrum in the blood and duodenal content were studied in 46 CP patients (20 patients with alcoholic pancreatitis--AP and 26 patients with biliary pancreatitis--BP) and 15 healthy controls.

RESULTS

In AP patients E-1 fell to 78.4 +/- 6.3 mcg/g (severe exocrine PI), while in BP patients E-1 was 170.0 +/- 28.9 mcg/g. CCK in AP and BP decreased to 0.33 +/- 0.03 and 0.45 +/- 0.03 ng/ml, respectively (control--1.60 +/- 0.02 ng/ml, respectively, p < 0.05). AP and BP patients had a rise in the absolute concentration and percentage of the total fraction of the taurodioxicholanic acids to 10.2 +/- 1.6 and 15.0 +/- 2.3%, respectively, (control 9.5 +/- 1.2%) in duodenal bile. The concentration of glycocholic acid fell to 24.1 +/- 1.6 and 23.7 +/- 3.7%, respectively, (control--36.4 +/- 2.4%, p < 0.05). AP patients had more significant decrease of taurocholic acid--to 4.5 +/- 0.7% (control--9.2 +/- 0.7%, p < 0.05). In the peripheral blood of AP patients there was an elevated basal level of serotonin and acetylcholine in the presence of low cholinesterase activity. After meal, acetylcholine concentration lowered in high secretion of serotonin.

CONCLUSION

Depending on severity of destructive changes in the pancreas, AP and BP patients had different degree of exocrine insufficiency which may be secondary to the absence of acetylcholine rise in the blood after meal. Alterations in the composition of the conjugates of cholic and taurodioxicholanic BA lead to alterations of CCK blood concentration and, therefore, to changes in exocrine pancreatic secretion. Imbalance between serotonin and acetylcholine levels after meal evidences for defects in conventional regulatory interrelations. Decreased threshold of nociceptors activation in simultaneous enhancement of afferent nociceptive flows may entail pain syndrome in CP.

[Pancreatic insufficiency in chronic pancreatitis of various etiology]

The goal of this study was to examine the severity of exocrinous and endocrinous pancreatic incompetence, composition of bile acids (BA) and hemostasis state depending on the etiologic form of chronic pancreatitis (CP). The study comprised 76 patients with CP at the age of 33-74 (46 females and 30 males), 20 of them having alcoholic pancreatitis (AP), 26 --biliary pancreatitis (BP), and 30--involutional pancreatitis (IP); 15 people (without any signs of gastrointestinal tract lesions) made up the control group. CP was diagnosed based on clinical data, laboratory and instrumental assessments. Various degrees of severity of exocrinous and endocrinous pancreatic incompetence were revealed depending on the CP etiology. AP patients had more marked alterations of this type depending on the severity and presence of complications. The study revealed changes in the quantitative and qualitative BA composition, which can cause reduced absorption of exogenous cholesterol in the CP patients' bowels and be one of the reasons affecting the exocrinous function of the pancreas. IP patients had more marked alterations of this type. All CP patients had blood hypercoagulation accompanied by a reduction of the public constant of blood coagulation, increase of the coagulation index and clot elasticity. Patients with the complicated course of the disease had more marked alteration of this type.

[Clinical importance of gut hormones]

The lecture includes materials on gut hormones. Descriptions of the main synthesis places as well as structure and functions of hormones are given. The introduction of radioimmunoassay and immunoenzyme techniques to clinical practice made it possible to reach a success in the field of studying gastrointestinal hormones. Basic gut hormones and their role in the control over functioning digestive system and body as a whole under normal and pathological conditions are given.

[Combination of cholelithiasis and duodenal ulcer: general nature of pathogenetic mechanisms]

Studies have shown that patients with cholelithiasis include a large group of people having associated duodenal ulcer as well. Duodenal ulcer also precedes cholelithiasis quite often (the ratio being 4:1), which makes it possible to consider duodenal ulcer as one of the risk factors for the duodenal ulcer development.

[Cyclic nucleotides and prostaglandins in gastric mucosa in ulcer formation in clinical medicine and in research]

The purpose of the study was to compare the nature of changes in the content of various groups of prostaglandins and cyclic nucleotides in patients with stomach ulcer as well as during the process of development and formation of experimental ulcers.

[Complicated form of chronic stomach ulcer]

Stomach ulcer is one of the most important problems of gastroenterology. Complicated, often recurring, giant and refractory stomach ulcers are most complex in the pathogenetic and treatment regard. The chronic and often recurring course of the disease, high percent of complications including such severe ones as perforation and bleeding, malignization, penetration and stenosis quite often result in a partial or complete disability in patients. As is well known, it is generally the most active and capable part of population that suffers from this disease.

[Adaptive and compensatory potentialities in cerebrovascular pathology]

The article presents current notions about some adaptive-and-compensatory mechanisms in cerebrovascular pathology, specifically in the augmented blood-filling syndrome. Multifactor pathologies, in particular vascular affections of the brain are proposed to be regarded as a model, the clinical realization of which model will permit revealing associations between genetic prepreparedness and compensatory-and-adaptive capabilities of the body in exposure to adverse environmental factors.

[Effect of prolonged dietary zeolites on survival rate and intestinal reaction toward irradiation in mice of different age]

In model experiments on mice the influence of prolonged dietary consumption of zeolites on a survival rate, an average lifetime and a status of adherent mucous layer of a digestive tube was investigated. It was found that zeolite increased a survival rate and average lifetime in 55- and 95-day old mice exposed to a dose of 4 Gy. Zeolite shivirtuin caused more expressed effect, than pegasin. Apparently, shivirtuin causes the more expressed radioprotective effect, because it does not hinder in the development of compensatory responses in a structurally functional status of adherent mucous layer of an intestine after the exposure.

[Forming of the Pavlov pouch changes functional condition of the adherent mucosal layer in upper regions of the digestive tract]

In result of forming the Pavlov small gaster, secretion of pepsine in isolated part and, probable, in other parts of the gaster, was increased. This entailed a decrease in the pepsin sorption level on the luminal surface of adherent mucous layer of the gaster parts and intestine under study. This led to a drop of the level of structure glycoproteins and to increase in the per cent contents of polymeric glycoproteins in the whole pool of the mucous layer glycoproteins. The data obtained suggest that forming of the Pavlov small gaster indices significant changes of the adherent mucous layer structure-functional condition both in the gaster and in lower parts of the intestine.

[The condition of the intestinal mucosa of the proximal digestive tract subjected sectioning of the jejunal wall]

The balance between secretion and degradation of the mucosa glycoproteins in the dog intestine is preserved with the aid of local reflexes in both serous-muscular and mucous-submucous layers of the wall. Irrespective of major alterations in the glycoproteins synthesis in the mucosa, protective properties of the submucous layer are maintained owing to a high content of acetylneuraminic acid and low level of mucous glycoproteins degradation.

[Functional state of the supraepithelial mucous layer of the digestive tract in mice in the postnatal period after irradiation]

It was studied the condition of mucous layer of intestine in mice model experiments after ionizing radiation. It were found out the differences in reaction of intestine on radiation in mice at the age of 55 and 95 days. In mice at the age of 55 days at the whole stretch of intestine was marked increased secretion of the polymeric glycoproteins, whereas in mice at the age of 95 days such alterations were marked at smaller degree. In both groups mice was marked increased secretion of bicarbonate after radiation, that is possible to count as characteristic compensative mechanism.

[Amizon in the treatment of nervous system involvement in herpes zoster]

The authors submit results of treatment of patients having suffered from postherpetic pain syndrome (herpetic ganglionitis of the cervical, thoracic, lumbosacral localization, postherpetic intercostal neuralgia, ganglionitis of the trigeminal nerve). In viral diseases, amizone has marked analgetic, antiinflammatory, and immunomodulating effects. The drug is well tolerated by patients, is not associated with side effects under prescribed doses (0.25-0.75 as one dose on a three- or four-times daily schedule during the course of treatment lasting three or four weeks). The drug preparation in question is less effective in the treatment of chronic recurring post-therapeutic intercostal neuralgias, radiculalgia.

[The clinico-rheoencephalographic characteristics of a hyperemia syndrome]

The author present comparative analysis of rheoencephalographic (REG) data obtained from 500 differently aged Kiev residents with atherosclerotic dyscirculatory encephalopathy after Chernobyl accident. Changes of principal REG parameters are determined as the plethoric syndrome (PS). Main variants of nerves characterizing PS are divided into three types. Data obtained by the authors confirmed changes of the vascular system under the new ecological conditions.

[Tympanic membrane prosthesis using soft magnetoelastomer]

This paper presents a new method for tympanum prosthesis application. The prosthesis is fixed by the interaction of magnetic pondermotive forces between two soft petals of a magnetoelastomer. This type of prosthesis was applied to 30 patients with dry perforative otitis media, aged 51-75 years. The intervention was performed in the outpatient department. Prostheses are recommended to be replaced every 3 months. These patients showed good tolerance of the treatment, which significantly improved their hearing level. The method of prosthesis fixation was reliable and atraumatic.