[The modern approaches to diagnostics of obstructive sleep apnoea syndrome]

The objective of the present study was to propose an optimal scope of diagnostic studies for the patients complaining of their snoring with a view to determining the expediency and strategy of the surgical treatment. The methods for cardiorespiratory monitoring and endoscopy of the upper air passages during medicamentally induced sleep were introduced in order to evaluate the severity of obstructive sleep apnoea syndrome (OSAS) and the level of obstruction of the upper pulmonary tract during apnoea episodes in the patients admitted to the Republican Research and Practical Centre of Otorhinolaryngology (Belarus'). The results of these diagnostic studies provide a basis for the choice of the strategy for the treatment of patients with OSAS.

Fluorescent probing of the ligand-binding ability of blood plasma in the acute-phase response

The acute-phase response alters the composition of carrier proteins in plasma, which may affect the blood deposition and transport of biomediators and drugs. The effect of the acute-phase response on the ligand binding ability of plasma was studied in leukemic children with and without systemic inflammation (sepsis and septic shock). To target different transport proteins, differentially charged fluorescent dyes were used: anionic ANS (8-anilinonaphthalene-1-sulfonate), uncharged Nile red, and cationic Quinaldine red. Human serum albumin was a principal carrier for ANS and competed for Nile red binding with lipoproteins. The synchro-scan fluorescence spectra of Nile red in plasma distinguished two species of the dye bound to serum albumin and to low-density and/or very low-density lipoproteins. The binding of Quinaldine red did not correlate with albumin and lipoprotein levels, and was probably determined by alpha(1)-acid glycoprotein. Compared with the control group, leukemia increased Quinaldine red binding by 65% and did not significantly affect the binding of other probes. Sepsis and septic shock did not change the binding of Quinaldine red, but progressively decreased ANS binding, finally by about 33%, and shifted Nile red distribution from serum albumin toward lipoproteins. These changes reflected a modified composition of the three principal transport proteins in plasma in the acute-phase response. Simple and rapid fluorescent tests developed in this study can be used to evaluate the acute-phase response and to optimize drug administration protocols in clinical practice.

[Assessment of body intoxication as a balance between accumulation and binding of toxin in plasma]

A novel approach to assessing endogenic intoxication (EI) as an imbalance between toxin accumulation and binding by albumin in blood plasma is proposed. The intoxication criterion (IC) is determined by the ratio of the content of medium-weight molecules (MWM) and effective albumin concentration (EAC): IC = MWN/EAC. In children with oncohematological diseases the development of EI is associated with a 4-fold drop of MWM content and a twofold decrease of EAC, and hence, the imbalance between these two values increases 9-10 times. The proposed approach notably improves the sensitivity of diagnosis of the early stages of EI. Application of a new fluorescent marker pirrone red for measuring albumin binding capacity is validated and an algorithm of EAC determination using calibration curve of probe binding to standard albumin solution is described.