Vol 32, No 1 (2015)

Aim. To assess the peculiarities of CD20+, CD4+, CD8+, CD56+ expression in placentas after premature detachment. Materials and methods. Histological material of placentas was divided into 4 groups. Group 1 ( n = 9) - placentas after premature detachment in the gestation period from 22 to 27 weeks. Group 2 ( n = 9) - placentas after premature detachment in the gestation period from 28 to 36 weeks. Group 3 ( n = 9) - placentas after premature detachment in the gestation period from 37 to 42 weeks. Group 4 ( n = 15), the control group - placentas of conditionally healthy women with uncomplicated pregnancy and labor. Immunohistochemical study included determination of CD20 (clone L26), CD56 (clone 123C3), CD8 (clone LT8), CD4 (clone W3/25) expression. Results. While analyzing the expression of CD20+ (B-lymphocytes) differentiation cluster in placentas after premature detachment, increase in their quantity is reliably more often assessed in groups 1 and 2. In the study conducted by us, there is statistically reliable difference in the expression of CD4+ differentiation cluster in placentas of women with premature detachment of placenta in the gestation period from 27 to 36 weeks, 19,2 ± 2,4. In the group of women, whose pregnancy resulted in premature detachment of placenta in the gestation period beginning from 37 weeks, this parameter is equal to 3,2 ± 1,1 that significantly differs from the group of conditionally healthy women. It is evident that premature detachment of placentas in the gestation period from 28 to 36 weeks CD4/CD8 index is significantly elevated till 5,33 at the expense of increased T-helpers, whereas in the other cases it is 0,75. Conclusions. 1. Irrespective of pathogenetic aspects predisposing to premature detachment of placenta, the number of NK-cells is growing in all placentas of women with this pathology: group 1 - 4,8±1,73, group 2 - 4,8 ± 1,2, group 3 - 6,4 ± 1,4, vs control - 1,4± 0,6. In groups 1 and 2, CD20+ expression is reliably more marked: 3,6 ± 1,73 and 3,3 ± 1,1, respectively, vs 1,0 ± 0,66 in group 3 and 0,8 ± 1,06 in the control group. In placentas of group 2, expression of CD4+ differentiation cluster is statistically significantly strengthened: 19 ± 2,4, vs 3,1 ± 0,6; 2,4 ± 0,53 and 4,6 ± 1,7 in groups 1, 3 and 4, respectively.

Aim. To characterize the presence and expressiveness of endothelial dysfunction in patients with ulcerous colitis (UC), to assess the correlation between endothelial lesion and severity of inflammatory process in the bowel. Materials and methods. Ninety patients (48 men and 42 women, the mean age 35,49 ± 10,87 years) with UC in the exacerbation phase were examined. The control group involved 50 healthy subjects comparable by sex and age. Blood serum vasculoendothelial growth factor (VEGF) was studied as the endothelial lesion marker. To estimate the functional status of endothelium, endothelium-dependent vasodilation (EDVD) was determined using finger photoplethysmography and the Software “Pulsware”. Results. The elevated blood serum VEGF level with the concentration median 256,65 (123,3; 375,8) pg/ml was assessed in UC patients that was three-fold higher than this index in the control group. In 95 % of UC patients there was observed disturbance of EDVD with the share of patients with significant decrease in PEF 76 %. Reliable correlation between endothelial dysfunction indices and degree of severity, UC localization as well as clinical and endoscopic activity of the process was revealed. Conclusions. Endothelial dysfunction manifested by elevation of blood serum VEGF level and fall in EDVD was detected in UC patients. The revealed disturbances confirm the hypothesis on participation of endothelial dysfunction in pathogenesis of ulcerous colitis.

Aim. To study the results of subjective symptoms and quality of life in patients with stage I-II chronic obstructive pulmonary disease (COPD) (mild and medium degree of severity) in 6 months after sanatorium-and-spa rehabilitation course. Materials and methods. 123 persons were under observation. All patients were divided into 2 randomized groups: main group and comparison group. The main group of patients received a basic complex including nitric-siliceous baths with decreased radon content and general magnetotherapy (GMT). The group of comparison had a basic complex alone. The patients filled in a form which was used to assess the manifestation of subjective symptoms and quality of life by “SF-36” test. Results. It was revealed that in the comparison group, growth of the basic subjective symptoms (cough, sputum, dyspnea) was reliably greater than in the main group. In 6 months after sanatorium rehabilitation, the quality of life indices in the comparison group were significantly lower than in the main group. Conclusions. Thus, GMT and nitric-siliceous baths with decreased radon content used for treatment of patients with stage I-II COPD lead to reliable preservation of the reached results by subjective symptoms indices and quality of life test.

Aim. To carry out the comparative study of phenotypic susceptibility/resistance levels of clinical stains N. gonorrhoeae to antibacterial drugs used for treatment of gonorrhea in Perm Krai. Materials and methods. Retrospective study of the spectrum of antibacterial drugs used in Perm Krai for treatment of acute gonorrhea was based on analysis of 1675 case histories of patients of different treatment-and-prophylactic institutions over the period of 2012-2014. The patients were divided by sexual character. Antibiotic susceptibility of isolated cultures was assessed with disco-diffuse method according to MG 4.2.1980-04 of RF Ministry of Health (2004). To study the correlation between signs, non-parametric Spirmen Rank Correlation coefficient ( R ) was calculated; the correlations were considered reliable at p < 0,05. Results. The overwhelming majority of strains (95 and 92 %, respectively) preserved a high susceptibility to ceftriaxone, more than 87 % of cultures appeared to be sensitive to spectinomycin and kanamycin. At the same time, more than 85 % of strains in both groups were resistant to azithromycin, ampicillin (87 and 85 %) and doxycycline (82 and 80 %). Conclusions. In Perm Krai, antibacterial phenotypic susceptibility/resistance of N. gonorrhoeae strains isolated from men and women ill with fresh acute uncomplicated gonorrhea of the lower parts of urogenital tract has no reliable differences. High susceptibility of infectious agents to ceftriaxione, spectinomycin was established that correlates with general Russian indices; clinical efficiency of cephalosporins was higher in treatment of men. It was stated that more than 80 % of N. gonorrhoeae strains manifested ampicillin, doxycycline and azithromycin resistance that, according to WHO criteria, makes their use for treatment of gonorrhea in Perm Krai inexpedient.

Aim. To asses the left atrium (LA) mechanical function in patients with ischemic mitral regurgitation (IMR) using technologies of vector analysis of endocardium movement rate. Materials and methods. The study enclosed 82 patients aged 59 ± 7,6 including 49 men (59,7 %). The entry criteria: EchoCG criteria of degree I-III ischemic mitral regurgitation, coronary artery lesions while fulfilling selective angiography corresponding to surgical revascularization criteria, sinus rhythm and normosystolia (heart rate from 60 to 89 per minute) during investigation, superior EchoCG visualization of LA endocardium. We suggest that atrial changes in deformation and deformation rate can be associated with severity of regurgitation. Results. Left atrium mechanical function indices decline proportionally to IMR severity. Longitudinal deformation and LA deformation rate reflect link with IMR greater than conventional indices used for estimation of LA geometry. Conclusions. Left atrium mechanical function indices are associated with IMR and connected with mechanical remodeling of the left atrium.

Aim. To study the morphological characteristics of the soft tissue septic wounds obtained by means of the developed models in animal experiment. Materials and methods. Ten Chinchilla rabbits of both sexes with the mass of 3000-3500 g were included in the experiment. During the study, a variant of modeling the submaxillary soft tissue phlegmona and infected musculocutaneous wound was offered by us to carry out experimental studies. Results. The studied morphological picture of septic wound was characterized by positive dynamics while local conservative treatment; by the day 14 after the operation there were practically no morphological signs of inflammation. Conclusions. The obtained data can be used as control during experimental study of new methods for treatment of septic-inflammatory processes of soft tissues.

Aim. To reveal the topographo-anatomic peculiarities of the structure of additional and multiple human renal veins by computer and multispiral computer tomography data. Materials and methods. Tomograms of 118 men and women obtained by means of spiral computer tomograph “Ultra Speed JE” and computer tomograms of 111 men and women in coronal projection obtained with computer tomograph “LightSpeed VCT” served as a material for investigation. Results. Kidneys with additional veins from the upper renal pole formed group 1 (12 observations). Kidneys with additional veins, which fell into the postcava higher than the level of the main trunk, but followed, unlike the previous group, from the renal hilum, formed group 2 (9 observations). Group 3 (5 observations) consisted of kidneys with additional veins from the lower renal pole which fell lower than the level of the main renal vein. In all the studied variants, presence of additional vein from the lower renal pole was associated with some peculiarities of topography of the kidney or its vessels. Conclusions. In 83,0 % of cases, a kidney has one renal vein, and in 17,0 % of cases there occur additional perforatory and multiple renal veins: additional veins were detected in 11,0 % of cases, perforatory veins - in 4,2 % of cases and multiple renal veins - in 2,0 % of cases.

Aim. To improve the measures for optimization of working conditions and workers’ health protection. Materials and methods. Hygienic studies were carried out in commodity production; instrumental measurements of industrial factor levels were performed according to operating regulations. Industrial environment factors and labor process were estimated by the degree of occupational hazard and danger by the Manual P 2.2.2006-05 “Manual for Hygienic Estimation of Labor Environment Factors and Labor Process. Criteria and Classification of Working Conditions”. Results. Working conditions of commodity production operators are characterized by a complex of factors including harmful air chemicals, noise, vibration, microclimate, light medium, hard and intensive work. At the same time, exposure of such labor factors as noise and operator’s intensity of labor was characterized by high intensity. A short-time excess of single maximum allowable petrol concentration is possible while fulfilling gas dangerous works. Conclusions. The results of this study permitted to ground scientifically the system of sanitation measures including organizational, hygienic, medical-preventive measures aimed at decrease in risk for development of functional disorders in operators’ body and risk for their health so as to prevent diseases.

Aim. To develop the proposals for elevation of the efficiency of international-legal mechanisms in fight with bioterrorism. Materials and methods. International-legal acts regulating the basic aspects of fight with bioterrorism were analyzed. Results. The Protocol for Prohibition of the Use in War of Asphyxiating, Poisonous or Other Gases, and of Bacteriological Methods of Warfare, signed in Geneva on July 17, 1925, does not enclose control standards, responsibility measures of states and procedures in case of violation. The Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxic Weapon and on their Destruction (April 10, 1972) has some essential disadvantages: the types and volume-quantitative parameters of biological agents and toxins to be used in peaceful purposes are not determined; no control mechanism; appeals to U.N. Security Council regarding the fact of violating the Convention positions does not guarantee the triumph of truth; unrecognized states can’t be participants of the Convention; responsibility of states, not participants of the Convention, is excluded. The Resolution 1540 (2004) adopted by the United Nations Security Council also has some drawbacks: lack of control for non-proliferation of biological weapons from specialized international organization having official status. Fulfillment of the Resolution is complicated by absence of well-defined uniform standards of international security effective for most states and absence of obligation to adopt the laws fixing the responsibility of non-official subjects for activity using mass destruction weapons. Conclusions. It is proposed to create a specialized international organization dealing with the problems of non-proliferation of biological weapons and control of international documents regarding the latter. It is necessary to develop and to adopt an international convention on fight with biological terrorism.

A clinicolaboratory description of the case of dermatological changes in a patient with terminal HIV-infection stage, which were characterized by development of some opportunistic skin infections (contagious molluscum, vulgar verruca, candidiasis, hairy leukoplakia) against the background of marked immune deficiency, is presented.