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Proceedings of the National Academy of Sciences of Belarus, Medical series

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No 4 (2015)

CLINICAL AND EXPERIMENTAL MEDICINE 

4-11 311
Abstract
There were 31 fragments of the coronary arteries investigated in patients who died in Minsk hospitals and who generally had clinical manifestations of coronary disease and diabetes mellitus. Heterogenic morphological lesions were detected in the coronary arteries which are characteristic for different stages of the atherosclerotic process from the imperceptible intima-media thickening to big complicated atherosclerotic plaques. At the same time, the fraction of the vulnerable plaques was between 0 and 0.94 (the mean value was 0.44 ± 0.24). As usual, the history of diabetes mellitus was associated with a higher quantity of unstable atherosclerotic plaques in the coronary arteries.
12-22 433
Abstract
So far, the issue of radiotherapy (RT) employment in the management of stage I low-risk endometrial cancer (EC) patients remains controversial. Stage IA, grade 1-2 endometrioid adenocarcinoma is qualified as low-risk. The paper presents the outcomes of surgical (ST) and combination treatment (CT) of low-risk EC patients between 2006 and 2010. There were three most commonly used treatment options in the CT group: 1) preoperative brachytherapy (PBT) plus surgery, its magnitude being hysterectomy with bilateral salpingo-oophorectomy (HS) (1239 patents); 2) PBT + HS + postoperative external-beam RT (ERT) (1051); 3) HS + ERT (429). A single PBT was performed on the day before surgery at a single target dose of 13.5 Gy, ERT was carried out with conventional fractions of 2 Gy up to a total target dose of 40-44 Gy. Overall 5-year survival with CT was 90.6 %, ST - 87.8 %, cancer-specific survival was 94.6 % and 94.5 %, respectively (р > 0.05). No statistically significant differences between CT and ST (р > 0.05) were found in overall and cancer-specific survivals for stage IAG1 EC without myometrium invasion and for stage IAG2 EC without myometrium invasion. Statistically significant differences in overall survival (р = 0.001) were documented for stage IAG1 EC with myometrium invasion up to 1/2 of its thickness; however, they were not observed in cancer-specific survival (р > 0.05). Overall and cancer-specific survivals for stage IAG2 EC with myometrium invasion up to 1/2 of its thickness appeared to be significantly higher with CT than with ST (р = 0.00004 and р = 0.002). The highest efficacy was attained using CT with PBT and/without postoperative ERT, compared with ST and other CT options. A differentiated approach to RT is needed for low-risk EC. RT is recommended to be completely rejected for stage IAG1-2 EC without myometrium invasion. It is possible to refrain from using RT for stage IAG1 EC with myometrium invasion up to 1/2 of its thickness. There are no reasons to completely reject RT for stage IAG2 EC. Further research is needed to assess the role of RT for stage IAG1-2 EC with myometrium invasion up to 1/2 of its thickness.
23-29 334
Abstract
The results of macroscopic and histological postoperative examination of the sequestered osteochondral bodies of 9 patients, in some cases having a «bridge-type» support by scar tissue and some mild signs of viability of these fragments, were presented in order to ground the appropriateness of their refixation in the bed. Studies showed that the presented removed osteochondral bodies are not viable, since in all histological specimens, the major pathologic features characteristic for nec-rotizing processes with degenerative changes of the cartilage cover are present. In 3 cases (33.3 %), the pathological changes similar to the histological structure with osteomyelitis processes are found. Judging on the results of morphological studies it can be stated that the refixation of the sequestered fragment has no pathologic grounding of the viability of the sequestrated body and has no sense because of possible complications and a very low probability of revascularization of the fragment after fixing it to the sclerotic bed.
30-37 444
Abstract
The immunomodulatory properties of fresh isolated uncultivated bone marrow mononuclear cells (BMMNC) were estimated. Revealed BMMNC expressed in vitro and in vivo antiproliferative effects on mitogen-stimulated rat splenocytes comparable with the mesenchymal stem cells immunosuppression, which offers the challenge of the BMMNC application in therapy of acute conditions with an inflammatory component including acute ischemic nephropathy for preventing ischemic organs affection long-term effects.
38-43 970
Abstract
The objective of the study was a search for new predictors of initial kidney transplant dysfunction. For this matter, the effluent of the preservation solution "Custodiol" in cadaveric brain dead donors was investigated (metabolites, electrolytes, osmolality, blood red cells count and hemoglobin). It was revealed that the osmolality of the effluent and its value > 97.3 mmol / kg at the stage of explantation is an independent predictor of renal graft dysfunction in the postoperative period.
44-50 532
Abstract
The objective of the work was to study the characteristics of regional microhemodynamics (MHD) in the face and to assess the complex treatment of patients with trigeminal neuralgia (TN). 27 patients were included in the study. They were divided into two groups: the main group was differentiated high-frequency rhizotomy + basic therapy + intravenous laser irradiation of blood (ILIB) + GAMK-ergic drug Phenibut. The control group was differentiated high-frequency rhizotomy + basic therapy. The parameters of skin microhemodynamics using non-invasive speckle-optical methods were studied at the beginning of hospitalization and in the end of the course treatment. In the both groups, there was a significant regression of the pain syndrome. The administration of ILIB and Phenibut for patients with TN contributed to the normalization of MHD in the skin.
51-55 482
Abstract
The immunohistochemical study of atherosclerotic coronary arteries, taken from the dead with coronary heart disease, found that the early stages of atherogenic lesions are characterized by the dominated expression of proapoptotic Bax protein that promotes the activation of apoptotic cell death. With the progression of atherosclerosis, the expression of anti-apoptotic factor Bcl-2 increases, which is a negative factor leading to the progression and destabilization of atheromatous lesions.
56-60 553
Abstract
In article the characteristics of modern methods of laboratory diagnostics of tuberculosis and the algorithm of microbiological diagnostics of tuberculosis and mycobacteriosis using modern diagnostic technologies (automated diagnostic systems and molecular genetic examinations) are provided.
61-67 385
Abstract
With the help of the mathematical modeling based on the solution of differential equations of second order, the oxygen distribution in tumors of simple geometric shape - spherical, cylindrical and flat layer, was calculated. The comparison of the parameters characterizing the oxygen distribution in tumors of simple forms shows the proximity of the values of these parameters, which allows the results to be used to estimate the oxygen distribution in tumors of arbitrary geometry.
68-84 1347
Abstract
М) in molar ratios of 1:1-1:100 (CI = 0.56-0.04). The components of such combinations are not only complementary another absolute anti-radical spectrum and biological activity, but also accelerate the radical interaction with each other and are considered as the basis for developing new cytoprotective and antioxidant drugs. It is also shown that the inclusion of an additional component in the synergistic combination can alter the character of the components interaction to antagonism and the resultant biological effect of the combination, which in turn indicates the urgent need for a comprehensive pre-clinical study of any drugs combinations.
85-91 351
Abstract
Validation of the model allowed finding thresholds, according to which one can interpret reasonably the model results. If the probability of the primary graft function is more than 0.89, then the satisfactory primary graft function is expected. If the result is within the range of 0.53-0.89, it is believed that there is a risk of the primary graft function. And if the result is less than 0.53, the unsatisfactory primary graft function is predicted. The software product "Kidney graft function calculator" has been developed based on the model built.
92-96 339
Abstract
This article is devoted to the study of the frequency and risk factors for adverse outcomes among patients with postinfarction cardiosclerosis. The study included 400 patients with a history of first myocardial infarction. The study found that within a year, recurrent myocardial infarction occurred in 92 (23 %) patients died of 26 (6.5 %) patients. The group of patients with recurrent myocardial infarction has a large number of people with depressive disorders that are associated with low levels of trait anxiety, anterior localization of myocardial infarction, a significant decrease in the contractile function of the left ventricle and the enlargement of the left ventricular myocardium, more frequent development of tachyarrhythmias, as well as an increase in the concentration of pro-inflammatory cytokines. For the group of patients with lethal characteristic family history of early coronary artery disease, the prevalence of individuals with situational anxiety, more frequent development of tachyarrhythmias, reduced the contractility of the myocardium and the left ventricular remodeling, higher values of total cholesterol and low-density lipoprotein, as well as the concentration of NT-fragment brain natriuretic peptide.

REVIEWS 

97-113 3076
Abstract
Medical genomics is one of the most rapidly developing areas of biological science. The boom in this area of medicine is observed in the last 25 years and is associated with the beginning of the international project «Human Genome». With the decoding of the nucleotide sequence of the genome, knowledge about genetic variability within the species, specific ethnic groups (detection of mutations, genetic mutations) linked the possibility of a deeper understanding of its biological significance in susceptibility to disease, resistance to environmental factors, including biological agents. Against the backdrop of accelerated development of structural genomics there is a significant delay in the development of functional genomics, ideas and mechanisms of the entire genetic apparatus (chromatin, structural genes and regulatory elements) as a whole in health and disease. Immunomics is a new direction to study the cells and genes of the immune system and their role in human biology. New technologies are the whole genome sequencing, the microarray technology and bioinformatics methods are increasingly used in medical practice, which ultimately brings the transition from selective genetic testing of persons with hereditary monogenic defects and diseases to a wider use and the availability of these methods for each person, which will create a scientifically based framework for personalized prevention and treatment of common monogenic and multifactorial diseases.
114-128 421
Abstract
-receptors and 5-HT transporter gene to an increased susceptibility to OSA.


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ISSN 1814-6023 (Print)
ISSN 2524-2350 (Online)