CLINICAL AND EXPERIMENTAL MEDICINE >
The results of experimental justification of a new method for restoring the femoral head bone tissue with the use of mesenchymal stem cells (MSCs) are presented. Surgical interventions were performed on 5 dogs, including the bone marrow exfusion, the obtaining of MSCs and their subsequent osteogenic differentiation, the selection of a carrier for MSCs, the creation of femoral head defects, and the implantation of a cellular product into a bone defect. Experimental animals were observed and cared after operations, and removed from the experiment, as well as the biological material was taken. The histological results of the femoral head micropreparations of dogs confirm the formation of the mature bone tissue of compact structure with osteoblasts at the site of MSCs injection. In the control group of the experimental samples (without MSCs), the The obtained experimental material will allow us to develop a method for autologous transplantation of MSCs for regenerative restoration of bone tissue damage in the adult’s femoral head osteonecrosis, which will find use in the practical healthcare system.
The article presents the results of a histological study of morphological changes in bone tissue around established dental implants after exposure to low-intensity, low-frequency ultrasound during dental implantation. Histological studies of tibia bone blocks were conducted in three groups of laboratory animals around installed dental implants, which were subjected to different modes of ultrasonic exposure. In the course of studies, it was found that the processes of osseointegration of dental implants in animals of all groups occurred without staging. In the early stages, granulation tissue was formed, which was subsequently replaced by reticulofibrotic bone tissue, and then by more mature lamellar tissue. The timing and degree of bone maturation, as well as the indicators of osseointegration in groups using low-intensity pulsed ultrasound and without it, were significantly different. It was shown that the ultrasound effect on peri-implant tissues induces osteoreparative processes, stimulating neoangiogenesis in granulation and newly formed bone tissue. It has been established that ultrasonic exposure of implants, and then peri-implant tissues during dental implantation, promotes the formation of bone tissue, the histostructure of which is similar to the histostructure of the maternal bone at earlier stages.
The experiments on rats and rabbits using modern physiological, biochemical research methods and the pharmacological approach established that in the body, the action of bacterial endotoxin, accompanied by fever, leads to a significant decrease in blood plasma and in CSF of the arginine content. In rabbits after 30 min intravenous administration of carbon-labeled arginine hydrochloride (25 μCi/kg) at the endotoxin fever peak (after the 60 min injection of endotoxine E. coli), the radioactivity level in the blood plasma decreases and significantly increases in the cerebrospinal fluid and the hypothalamus tissue. It was revealed that although the content and speed of norepinephrine turnover in the hypothalamus after the introduction of L-arginine hydrochloride (100 μg) into the ventricles of the rats does not change in comparison with control animals, however, the chemoreactive properties of the thermoregulatory structures of the brain have changed, which manifests itself in the change in the expression and duration of thermoregulatory effects of the central action of norepinephrine and acetylcholine. It was established that the administration of L-arginine hydrochloride into the brain ventricles at a dose of 100 μg per animal or in the blood flow at a dose of 20 mg/kg caused the pronounced antipyretic effect. It was found that L-arginine hydrochloride (100 μg), after it has been introduced into the ventricles of the brain, increases the impulse activity of heat-sensitive neurons of the medial preoptic region of the anterior hypothalamus in rabbits due to a brain temperature growth when the animal’s body is overheated. Apparently, CSF arginine can be considered as an important factor in the changes in the excitability thresholds of cold and heat-sensitive neurons in the hypothalamus and in the formation of the “setpoint” of body temperature regulation during endotoxin fever.
The myocardial bridge (MB) is a congenital anomaly, in which a segment of a coronary artery courses through the myocardium. The aim of the study was to establish the location of myocardial bridges and the severity of atherosclerotic lesions of the coronary arteries in patients with coronary heart disease symptoms and in individuals who are the potential heart donors for transplantation. The data of the multislice computed tomography coronary angiography of the patients of the Republican Scientific and Practical Centre “Cardiology” from 2016 to 2018 were included in this study. 324 hearts of the deceased donors, which had not been used for orthotopic transplantation, were studied. According to the autopsy and the CT coronary angiography, the myocardial bridges were localized mainly in the left anterior descending artery of the left coronary artery (LCA). In 7.4 % of cases, MBs were found in a distal portion of the intermediate branch of LCA, in the left postero-lateral branch, in the right coronary artery, in the first diagonal artery, as well as along the obtuse marginal artery and the left circumflex coronary artery. In 36 % of cases, the identified bridges were considered as hemodynamically significant with regard to the length of the tunneled artery segment and its depth. Microscopic examination of the tunneled fragments of the coronary arteries in 4.9 % of cases showed the initial signs of damage of the vessel wall in the form of fibromuscular dysplasia and lipidosis. According to the CT coronary angiography results, no causal relationship has been established between the presence of MBs and atherosclerosis in the subepicardial segments of the coronary arteries.
The cross-sectional study of the patients receiving hemodialysis (HD) treatment in the dialysis departments in Minsk at the beginning of the year 2017 was made. The aim of the study was to define the main cause of the end stage renal disease (ESRD) among HD patients in the dialysis departments in Minsk. According to the inclusion and exclusion criteria, 289 patients were selected for further analysis. The median of the age was 57 (45; 66) years, for men it was 174 (60.2 %) years. The median of therapy duration was 26 (8; 66) months. The main cause of the end stage renal disease was chronic glomerulonephritis in 35.3 % of patients, the second was diabetes mellitus in 15.9 % of patients, and the third was the polycystic disease in 13.5 % of patients. Kidney damage in the frame of ANCA-vasculitis was revealed in 4 (1.4 %) patients, which is less than in Eastern European Centers where systemic vasculitis is the cause of ESRD in 6.7 % of cases. Histological verification of the diagnosis was conducted in 25 (8.7 %) patients while the most frequent diagnosis was IgA-nephropathy tht was defined in 44 % of biopsied persons. The results of our analysis point to an insufficient rate of histopathology that proved the diagnosis among of the HD patients in Minsk. It does not allow us to conduct a complete differential diagnosis between kidney damage due to the primary diffuse kidney disease or arterial hypertension, diabetes mellitus and systemic vacuities.
Ultrastructural changes in the liver of rats after 7and 21-days intragastric administration of tenofovir disoproxil fumarate (TDF) at a dose of 50 mg/kg/daily and correction of the revealed violations by S-adenosylmethionine (SAM) were described. Exposure of TDF for 7 days causes mild dystrophic changes in a small proportion of hepatocytes. The 21-day effect of TDF in the hepatocytes of the periportal zones shows the development of moderately pronounced dystrophy with a decrease in protein-synthetic function and slight changes in the structure of mitochondria. At both periods of administration, TDF leads to the death of single cells of the liver parenchyma and reactive intralobular inflammatory infiltration. The use of SAM on long-term administration of TDF does not reduce the intensity of core liver infiltration, but prevents the development of dystrophy of peripоrtal hepatocytes and normalizes the amount of lipid inclusions in parenchymal cells of the organ.
Extracorporeal blood purification (EBP) is one of the trends of effective sepsis therapy. Some disadvantages of this method such as a possible reduction of plasma levels of different important metabolites are described. It is known that sepsis disorders of amino acid metabolism are manifested in microcirculation interruptions, the decreased immune response and the increased mortality. The aim of the study is to investigate the EBP effect on the essential amino acid plasma levels in patients diagnosed with sepsis. We selected 38 patients diagnosed with sepsis. Standard treatment protocols of plasma filtration, hemofiltration, and hemadsorption with various sorbents were used. We revealed a significant decrease in the levels of valine, methionine, tryptophan, isoleucine, phenylalanine, leucine, and lysine in patients who underwent hemadsorption by the sorbent “Proteasosorb”. Hemadsorption by the sorbent “Proteasosorb” has the greatest effect on the levels of amino acids.
The high prevalence of the vitamin D (VD) deficiency states (VDDS) among adults, as well as the data on the pleiotropic effects of calcitriol suggests its participation in the development of various complications and pregnancy outcomes. The objective of the present study is to analyze the pregnancy course and delivery tactics of pregnant women with placental dysfunction (PD) depending on the calcitriol availability. We examined 56 patients with PD (I – main group) and 40 conditionally healthy women with physiological pregnancy (II – control group). In addition to the standard clinical and laboratory examination, the level of vitamin D in the blood was determined by ELISA. The statistical analysis used the software Biostat, Statistica 6.0. In 76.8 % of group I women, the VD content corresponded to the deficit (38.4 %) and to the suboptimal status (38.4 %), (RR = 3.0; 95 % CI 2.39–3.76). In group II, VDDS was not detected and the suboptimal status was diagnosed in 31.45 %. The average VD level in group I was significantly lower than that in group II (31.4 ± 8.6 ng/ml vs 43.54 ± 11.2 ng/ml; Uemp = 42.5; p < 0.05). The caesarean section rate in group I was 3.4 times higher than that in group II (42.85 % vs 12.5 %; F = 0.00001; p < 0.01). The weight of newborns in group II significantly exceeded the weight of children in group I (3643.24 ± 136 g vs 3299.11 ± 128 g; t = 4.17; p < 0.01); a strong direct correlation was found between the weight of the newborn and the VD level in the blood of pregnant women (r = 0.71). VDDS increases 2 times the risk of abdominal delivery (RR = 1.27; 95 % CI 0.95–1.66). The VD status of a pregnant woman can have a certain influence on the formation of optimal adaptive-compensatory mechanisms in the utero-placental-fetal system and on the pregnancy outcome for mother and fetus.
The objective is to study the effect of umbilical cord blood endothelial cells on the hematopoietic cells growth and the maturation in the erythroid direction in co-culture, as well as the expression of adult and fetal hemoglobin genes during erythroid differentiation under the conditions of vascular niche modeling in vitro. We used the following research methods: cultural, flow cytometry, real-time PCR and morphological analysis. We have developed the method of hematopoietic cord blood stem cells erythroid differentiation in co-culture using cord blood endothelial cell progenitors. CD34+CD31+CD144+CD105+CD90–CD45– progenitors of endothelial cells stimulate the erythroid differentiation of hematopoietic CD34+ cord blood cells and the growth of erythroid progenitors in co-culture from the 4th to 11th day in the presence of the stem cell factor, the erythropoietin and the fibroblast growth factor-2. The in vitro modeling of the vascular niche increases the mature CD36–CD235a+ erythroid cells 2.5 times higher than those in the liquid culture. The microenvironment of endothelial cells does not affect the level and expression ratio of fetal and adult hemoglobin during the erythroid differentiation in vitro.
The prevalence of congenital ectopia lentis is 7–10 cases per 100 000 people. The most common causes of congenital lens displacement are the FBN1 gene mutations that have been found in 25–85 % of patients with this pathology. The aim of the study is to establish the FBN1 gene mutations in patients with congenital lens displacement and in their families. The study group included three families with children and adults suffered from the congenital lens dislocation. The nucleotide sequence of the FBN1 gene was analyzed by direct sequencing. The pathogenicity of the identified mutations was assessed using the Ghent criteria revised in 2010. The mutation c.1884C> G (p.Cys628Trp) in the heterozygous state in the 16th exon of the FBN1 gene was detected in proband 1 and her brother. Proband 2 was found to be a heterozygous career of the mutation c.2461T> A (p.Cys821Ser) in the 21st exon; this mutation was absent in parents and a healthy brother. The mutation c.7851delС (p.Cys2617Trpfs*65) in the heterozygous state in the 64th exon was identified in proband 3 and her mother. In accordance with the revised Ghent classification and the clinical manifestations and molecular genetic studies, Marfan’s syndrome (MS) was diagnosed in all probands and their affected relatives. We detected three pathogenic mutations not previously described in the literature in the 16th, 21st, and 64th exons of the FBN1 gene in patients with congenital ectopia lentis caused by MS. We established the spectrum of clinical manifestations of MS characteristic for the identified mutations.
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The article reviews the information on the problem of psychosomatic disorders (PSDs) widespread in human population. Attention is drawn to the insufficient awareness of general practitioners in this field of pathology. The true-life situations are considered that the cause development of PSDs and the role of negative thoughts and an emotional factor in their development. A general scheme of the PSD pathogenesis is suggested, which is based on the shift in the balance of the excitation and inhibition processes in CNS towards the prevalence of the former ones. Suppression of the inhibitory processes results in the decrease of the excitation thresholds of different afferent systems and in the development of general hyperesthesia that causes the organism hyperreactivity to the external and internal actions, including the subthreshold ones and stimuli. This underlies the mechanism of PSD clinical manifestations. A possible role of CNS stagnant centers of excitement in the development of PSDs and their ability to migrate in the brain, which reflects the migration of PSD symptoms in the organism, are viewed. Mental, neurologic, cardiovascular, respiratory, digestive, urination, sexual and skin manifestations of PSDs are discussed. General approaches to treating PSD patients are considered. The fundamental importance of the mood factor in the PSD development and alleviation is substantiated.
The review presents an analysis of current scientific data on the role of ductal secretion disorders in the pathogenesis of chronic pancreatitis. It is shown that under the influence of alcohol or other provoking factors, the CFTR transport mechanism of duct cells undergoes damage, which leads to the decrease in the bicarbonate and fluid secretion. Dehydration and acidification contribute to the hyperconcentration of protein and mucous components of pancreatic secretion and to the change in its rheological properties, which complicates further transport through the ductal system. Current conditions are favorable for the formation of mucoprotein plugs and the ductal obstruction that may have an important role in the pathogenesis of chronic pancreatitis at the early stage of development of the disease.
ISSN 2524-2350 (Online)