№3, 2009, volume 5

В статье анализируются причины роста аномалий развития плода и новорожденного от женщин группы риска по этой патологии. Предлагается программа ранней пренатальной и постнатальной диагностики, профилактики и коррекции врожденных пороков развития. Реализация предложенного комплекса мероприятий позволила повысить возможности выявления врожденных пороков развития, снизить число инкурабильных случаев, уменьшить летальность и инвалидность

Research Objective — study of bone tissue remodeling features at aseptic instability (Al) of the femoral endoprosthesis in patients with coxarthrosis according to a level of biomechanical markers of bone resorption and formation.
41 patients with coxarthrosis have been examined, a primary total hip replacement was carried out in 27 patients of them (the comparison group), the endoprosthesis re-replacement was performed in 14 patients of the basic group with endoprosthesis Al. Among the examined patients there were 20 men and 21 women aged from 46 to 67. The control group contained 13 donors. All the patients were made double-energy x-ray absorptiometry, formation markers (osteo-calcin and alkaline phosphatase bone isoenzyme) and bone resorption (C-terminal first type collagen telopeptide) and calcium — phosphoric metabolism state were determined. The significant data were considered to be the data with probability index p<0,05.
Bone tissue remodeling imbalance at Al of the femoral endoprosthesis in patients with coxarthrosis was characterized by the expressed prevalence of resorption processes over the osteogenesis, and higher speed of metabolic processes were expressed more in the group of the men with Al.
The hip re-replacement at implant Al is carried out in metabolically unfavorable conditions of bone remodeling. The impartial assessment of Al features at the presurgical stage will allow to fulfil the adequate medicamentous correction of available abnormalities

There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging), endoscopic (fibro-optic bronchoscopy) and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme) was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method.
Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

Patients of middle and old age with ischemic heart desease and diseases of urinary system (DUS) have been examined. Leukocytic index of intoxication (Lll), hematologic parameter of intoxication (HPI), parameter of immunity intensity (Pll) have been significantly increased in groups of patients with benign prostatic hyperplasia, diabetes and DUS. These indices have been directly correlated with content of IL6 and TNFa, and examined autoantibodies (AAb), especially with contents of antibodies to DNA, to collagen, to fiber-regulator of differentiation and migration immature neuroblast S100. Indices of Lll, HPI and Pll have been decreased in group of patients with normal body weight and urolithiasis. In this group the increase of allergization index (Al) and content of IL6, TNFa has been noticed. Indices of AAb pointed to metabolic disorders. The increase of cytokines in patients with pyelonephritis has been revealed. Content of AAb has been slightly increased in comparison with normal indices

Glaucoma simplex is one of the basic causes of blindness. The main problem of glaucoma is its early recognition. It's well known that changes of anatomic structure of each organ are preceded by functional disorders, including disturbances of hemodynamics. Method of computer colorimetric analysis of disk of optic nerve (DON) was worked out for the purpose of objective evaluation of its chroma as one of hemodynamics detection criteria. Computer program for analysis of DON chroma with calculation of integrated index (color index) was developed. DON chroma was analyzed in the group of persons suspected of glaucoma, in the group of patients with glaucoma simplex and in healthy people. This method along with confocal scanning tomography of DON allows to evaluate objectively in dynamics its state in the presence of glaucoma simplex. These methods are necessary to be used in complex for diagnostics of early stages of glaucoma simplex.

A new follow-up technology of dynamic out-patient control based on system of mobile monitoring of patients with arterial hypertension (SMMAH) has been created in Saratov Scientific Research Institute of Cardiology. SMMAH is based on exchange of information between patient and doctor with the help of Internet and standard short mobile messages. The aim of the present work is to study the effectiveness of SMMAH for follow-up control of hypertensive patients for the period of 12 months. 79 patients with hypertension aged 49±11 were included in the investigation. Control period lasted 12 months. Control visits were made in the 1st, 6th and 12th months. The number of patients became out of control, its causes, percentage of patients who achieved and maintained target blood pressure (BP) were analyzed after each visit. Data were presented as M (95% confidence interval). As a result in 1 month period of investigation 88,6% of patients regularly used mobile messages, 11% of patients were out of control. In 6 months period 68,4% of participants were under control, 31,6% of patients dropped out. In 12 months period — 67% and 33% of patients accordingly. Target BP was maintained in 87% (77%-96%) of patients in 1 month period, in 78% (66%-90%) of patients in 6 months period and in 68% of patients (53%-84%) in 12 months period. High clinical effectiveness of SMMAH has been proved during the study: 67% of patients have followed prescribed therapy after the investigation period and 68% of them have maintained target BP level.

The goal of the present research is to define correlation of disease exacerbation risk within the next month and sleep-wake regimen changes in patients with gastroesophageal reflux disease. 40 patients with remission have been examined three times a week to determine qualitative and quantitative indices of sleep characteristic. During the following month the dynamic examination of the mentioned group of patients has been carried out for the purpose of timely acute condition diagnostics. It has been revealed that disturbances of sleep indices, such as late falling asleep, long-term falling asleep, frequency of awakening and unpleasant dreams become unfavorable risk factors for the development of the next recurrence of gastroesophageal reflux disease during the nearest month, but the remission of this disease is significantly connected with falling asleep duration and awakening time.

The characteristics of heart remodeling in patients with chronic obstructive pulmonary diseases ( COPD), associated with coronary heart diseases (CHD) were examined. The changes of structural and functional state of myocardium, intracardiac relationships with associated pathology were under study. The role of blood inflammatory cytokines (IL-6, IL-8, TNF-a) and the level of cell adhesion molecules (ICAM-1, VCAM-1) in exacerbating myocardial dysfunction was clarified.

Purpose — Studying of kliniko-morphological features of a pathology of a gullet, stomach, duodenal gut and role of indicators apoptosis and proliferation in pathology development esofagogastroduodenal zones at alcoholic liver disease.
42 patients with an alcoholic hepatitis and 44 patients a cirrhosis are surveyed. By all it is spent endoscopic, histo-logic and immuno-histochemical inspection. By means of sets of antibodies studied proliferation activity epitheliocytes of stomach
At patients at transformation of a chronic alcoholic hepatitis in a cirrhosis accrue atrophy changes of a mucous membrane of a stomach, against against which chronic erosion or peptic ulcers without inflammations are marked. Processes proliferation and apoptosis are activated, that to the full defines morphological changes gastroduodenal zones
Strengthening of processes proliferation and apoptosis promotes progressing of structural changes esophagogas-tricduodenal zones that can serve additional diagnostic and prognostic as criterion.

The examination of morphofunctional features of esophagus, stomach, and duodenum as well as the role of diffusive endocrine system's cells in development of esophagogastroduodenal zone in patients without gallbladder is the purpose of the study.
80 patients with various periods after cholecystectomy and 72 patients with cholelithiasis were examined. Endo-scopic, histological and immuno-histochemical studies were carried out against all examined patients. The amount of epitheliocytes producing motilin (EC2), glucagon (L), and pancreatic polypeptide (PP) in duodenum were determined using antibodies sets. Esophagitis, atrophic- and reflux-gastritis, duodenal reflux are positively rather frequently met, atrophy and dysplasia of gastric mucous membrane increase in patients without gallbladder during the time after cholecystectomy. Hypoplasia of epithelial cells producing motilin, glucagon and pancreatic polipetide progresses. The development of duodenal and gastroesophagial reflux is associated with hypoplasia of epithelicytes producing motilin; the development of erosive changes is connected with hypoplasia of L and PP cells; the development of atrophic changes is closely related with hypoplasia of all studied cell types. The decrease of hormone producing epythelicytes promotes initiation and persistence of morphofunctional changes in esophagogastricduodenal zone. And this in turn can serve as additional diagnostic and prognostic criterion.