Vol 17, No 1 (2017)

Realization of the role of endothelium as an independent organ in the unified syste m of regulation of blood circulation and realization of endothelial dysfunction as a key component of the pathological condition that is connected w ith most factors,if not to s ay with all factors of the cardiovascular risk,has led to the w homping increase of researches of endothelium during the last three decades. Methods of estimation of the regular vascular (endothelial) function are used widely in scientific researches; but their usage as a clinical tool in the daily medical practice is still an exception. The proposed overview contains the description of the most popular methods of estimation and monitoring of the vascular function by taking into consideration the possibility of their application in the practical medicine. In particular, data about the reason are provided why the endothelial disfunction is not only a risk marker for cardiovascular pathologies, but also contains the valuable prognostic information for the secondary prevention of diseases and management of patients suffering with the ischemic heart disease, hypertension or with the lever pathology that have already been determined. For the clinical application methods of estimation of the function of the endothelium that are simple, accessible , and light for patients are the most perspective methods. However for using them in the daily clinical practice the next following goal-oriented researches in this direction are necessary. Their task is to determine it , how and in which cases it is goal-oriented,to use such estimations; how do they influence the choosing of the treatment, and which clinical effect of application of these methods at the treatment of concrete diseases is awaited.

The most frequent problem of the surgical treatment of the phlebeurysm is the repatency of thrombuses. The main cell population that prevents the formation of thrombuses and contributes to their repatency is presented by endotheliocytes of intima of vessels. One of important directions of the contemporary immunomorphological angiology is determination of markers of the functional activity of the endothelium that has the high predictive validity in relation to the prediction of results of the surgical treatment. The possible expectant to be such a marker is the protein that is synthesized with endotheliocytes, it is called von Willebrand factor. In the present article data are generalized and analyzed that are available in the literature worldwide concerning the molecular organization and functions of von Willebrand factor, the comparison of different morphological ways of its detection in situ has been carried out. Based on the overview of literature and own data a conclusion has been drawn that the method of the confocal laser microscopy makes possible in course of the immunocytochemical marking of the von Willebrand factor to study its distribution in the cytoplasm of separate endotheliocytes as well as in the subendothelial area of the wall of the blood vessel. Data on the intracellular and extracellular accumulation of the von Willebrand factor are necessary for the correct evaluation of the functional state of the endothelial lepidic tissue.

The purpose of the present study is study of the clinical and prognostic value of the heart remodeling at patients suffering with the acute coronary syndrome (ACS). The echocardioscopy of 71 patients suffering with the ACS has been carried out. Additionally the prognosis of the disease was estimated by using the Grace scale. Opinion: the tendency to the dilation of the right atrium of patients suffering with the ACS without increase of the ST segment, as a compensatory component, contributes to the benign outcome to the instable angina. The tendency to the dilation of the left atrium of patients suffering with the ACS with the increase of the ST segment, as well as the reduction of the ejection fraction of the left ventricle, increase of pressure in the pulmonary artery are factors of decompensation that are indirect representatives of the damage of the myocardium of the left ventricle. The most negative factor of the lethality is the damage of the systolic function of the left ventricle. Conclusions: the heart remodeling in case of the ACS is represented with the damage of the function and architectonics of the organ, stages of compensation and decompensation of the disease process, it has the clinical ant prognostic meaning during the hospitalizing and within the next following semi-annual time period.

Actuality and purpose. Taking into consideration the paucity of scientific publications concerning factors that deepen the course of the chronic hepatic encephalopathy, the purpose of the present research was the study of characteristics of parameters of the cerebral circulatory dynamics in extra- and intracranial departments with dyscirculatory damages in course of hepatic cirrhoses that have the viral causation of the classes А, В, С in accordance with the Child and Pugh score for improvement of the optimization at the early detection of complications of the encephalopathy at different stages of its development. Material and methods of researches. In the course of examination of 107 patients suffering with hepatic cirrhoses that have the viral causation of the classes А, В, С accordance with the Child and Pugh score the circulatory dynamics in common carotid arteries and medial cerebral arteries of the 1st order of the both hemispheres was examined. Results. The chronical hepatic encephalopathy in up to 75 % of cases can proceed in the comorbidity with dyscirculatory cerebral damages that have been caused primarily at the expense of the process of the atherosclerosis, tortuosity of arteries and the imbalance of the vascular tone. In common carotid arteries against the background of the thickening of the intima-media complex from 0,69±0,21 mm up to 0,79±0,35 mm the tendency to the development of the hemisphere asymmetry of the linear speed of the blood flow from 25.1±2,42% up to 39,5±7,94% is noted against the background of the hepatic cirrhosis of the classes A and С correspondingly. The highest statistical significance of differences is noted between values of the intima-media complex, of the hemisphere asymmetry with the medium linear speed of the blood flow against the background of the hepatic cirrhosis of the С class and the norm. In medial cerebral arteries the most serious damages of parameters of the circulatory dynamics are observed in case of the hepatic cirrhosis of the class С due to change of speed values of the blood flow, increase of the hemisphere asymmetry of the middle linear speed of the blood flow up to 33,9±10,5%, lowering of resistance and pulsatility indexes amounts up to 0,49±0,22 and 1,02±0,21 correspondingly. The highest statistical significance of differences is noted between speed values of the blood flow, values of resistance and pulsatility indexes, values of hemisphere asymmetry of the medium linear speed of the blood flow in case of the hepatic cirrhosis of the С class and the norm. At the comorbidity of hepatic and dyscirculatory encephalopathy the increase of the time of binding of figures belonging to the Reitan test is noted. At that the influence of stages of the dyscirculatory encephalopathy on the process of stages of the hepatic encephalopathy is not single-valued, and it depends on their stages of compensation. Conclusions: 1. In case of hepatic cirrhoses the chronical hepatic encephalopathy in 75% of cases proceeds against the background of dyscirculatory damages, from minimal up to nonreversible, that have been confirmed in 45% of cases only with methods of the instrumental diagnostics, and they increase the clinical process of the dyscirculatory encephalopathy. 2. The influence of stages of the dyscirculatory encephalopathy on the process of stages of the hepatic encephalopathy is not single-valued. The minimal influence is noted at the 1st stage of the hepatic encephalopathy, the maximal influence is noted at the hepatic encephalopathy of the 3rd stage in the comorbidity with stages of the dyscircula-tory encephalopathy. 3. The presence of the hemisphere asymmetry of the blood flow speed (more than 40%), lowering of speed parameters of the blood flow lower than reference values and resistance index (lower than 0,35) in districts of cerebral arteries are indicative of the poor prognosis of the progress of the encephalopathy due to the possibility of the appearance of the “sausage-string” phenomenon with the danger of the development of acute damages of the cerebral blood flow of the haemorrhagic type, process of the venous stasis and cerebral edema.

The purpose is: to study the antitumor effect of implantation of barium hexaferrite to SHR mice with unilateral and bilateral lymphosarcoma LIO-1. On SHR mice with unilateral and bilateral lymphosarcoma LIO-1 the intratumoral injection of the hard magnetic ferromagnetic material - barium hexaferrite (BaO•6Fe2O3) has been studied. The barium hexaferrite has the antitumor effect at its implantation into the center of the lymphosarcoma LIO-1 to SHR mice suffering with the unilateral tumor. The suppression of the growth of the both neoformations of the bilateral tumor LIO-1 (tumors in the left and right hind limb of SHR mice) in case of implantation inly into one limb with the tumor has been detected. As a result of the morphological study it has been shown that the barium hexaferrite is localized in the tumor securely, into that it has been implanted at the bilateral variant of the LIO-1, and it doesn’t make possible for tumor cells to invide into regional lymphonodi.

Many bacteria, including Streptococcus pyogenes are able to suppress the development of tumors as at humans as at other mammals; however, mechanisms of the antitumor activity of bacteria are still unknown. Data about the role of the arginine deiminaze of streptococci as an important antitumor agent have been published. Purpose: in the present study the role of the arginine deiminaze in the antitumor activity of bacteria has been studied. Materials and methods: in course of performed studies the influence on the progress of tumors for cultures of two strains of Streptococcus pyogenes with the serotype M49 was compared: the M49-16 and M49-16delAD strains that produce the arginine deiminaze and that don’t produce it. In the first group of experiments performed in vitro, the culture of cells of hepatoma of 22a mice was affected by streptococci. Results: by means of the xCELLigence system (ACEA, USA), that makes possible to evaluate the condition of the culture of the tissue on a real-time basis it was shown that only streptococci that produce the arginine deiminaze have the cellulotoxic activity. During the second group of experiments performed on laboratory animals suffering with M37 sarcoma it was determined that the administration of streptococci that produce the arginine deiminaze into the tumor caused the decrease of the dimension of the tumor and as well as the decrease of the mortality of animals. The administration of streptococci that don’t produce this ferment did not have such effect.

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